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Medi-Cal AWP fraud suit expands

Executive Summary

California Attorney General sues 39 pharmaceutical manufacturers for reporting inflated prices to the state's Medi-Cal Medicaid program. The suit, filed Aug. 25 in U.S. District Court in Boston, is an expansion of a 2003 California whistleblower suit against Abbott and Wyeth. Suit adds 38 defendants; Wyeth was dropped from the list of defendants after further investigation, the AG's office said. The defendant includes a variety of manufacturers: including both brand firms (Amgen, GlaxoSmithKline, Bristol-Myers Squibb and Novartis) as well as generic firms (Roxane, Mylan, Sandoz and Teva). Notably absent from the suit are Lilly, Merck, Pfizer and Johnson & Johnson. The suit alleges that the firms defrauded the state by reporting inflated wholesale prices to pricing compendia, which Medi-Cal used to determine physician reimbursement rates. California is one of a number of states suing manufacturers for pricing fraud based on data provided by whistleblowing pharmacy Ven-A-Care (1"The Pink Sheet" Oct. 1, 2001, p. 12)...

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