Settlements

Pharmaceutical costs are a significant portion of the Medi-Cal Program’s budget. During fiscal year 2015-2016, the Medi-Cal Program’s overall fee-for-service pharmaceutical costs were approximately $4 billion ($3,945,500,000). The Department of Health Care Services works closely with the Office of Attorney General, Bureau of Medi-Cal Fraud & Elder Abuse, to protect the Medi-Cal Program from fraud through investigations and prosecutions. Civil pharmaceutical litigation frequently involves multiple states and the United States, often initiated by a private citizen or “whistleblower,” in the form of a civil lawsuit filed against pharmaceutical companies in federal or state courts. These cases, also referred to as “qui tam” actions, often involve numerous allegations of violations under the State and Federal False Claims Acts, such as kickbacks or unlawfully inflated drug prices. Settlement Agreements entered into by Defendant(s) and the State are a compromise of disputed claims. A Settlement by a Defendant is neither an admission of facts or liability, nor a concession by the State that its allegations are not well founded. Recent settlement recoveries posted below may not include applicable interest which accrues until payment is made. Investigations and prosecutions have resulted in the following recoveries related to pharmaceutical claims during 2015 -2016: