Amerigroup ruling sends warning against healthcare discrimination Commentary
Amerigroup ruling sends warning against healthcare discrimination
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Lisa Madigan [Attorney General of Illinois, on the recent discrimination verdict against Amerigroup]: "Evidence at the trial established that from 2000-2004 the state of Illinois and the United States paid Amerigroup Corporation and its Illinois subsidiary over $243 million to set up a Medicaid HMO in Illinois that would provide healthcare services to Medicaid recipients. Amerigroup instead engaged in a systematic scheme to avoid enrolling the very people they were paid to serve, the chronically ill and pregnant women. By secretly working to enroll only the healthy people, Amerigroup was able to spend less than 50% of what they were paid on actually providing care while other HMOs in Illinois were spending between 80%-90%. The scheme was brought to the attention of the United States Attorney and the Illinois Attorney General by Amerigroup's former vice president for government relations, Mr. Cleveland Tyson.

The jury found that Amerigroup and its subsidiary submitted over 18,000 false claims for payment to the governments. The jury found that these claims were based on Amerigroup's fraudulent promises that they would not discriminate against people based on a person's health status. The jury awarded Illinois and the U.S. $48 million in damages. This amount will be automatically tripled under the federal False Claims Act and its Illinois companion statute, the Illinois Whistleblower Reward and Protection Act, to $144 million plus mandatory penalties potentially totaling in the hundreds of millions. The verdict has been reported to be the largest verdict in the history of the False Claims Act and the largest civil verdict in the history of the Illinois Attorney General's office.

The verdict will both reimburse the state of Illinois for the money Amerigroup obtained illegally and punish Amerigroup for their unconscionable conduct. It sends a strong message that companies who contract with the State of Illinois to provide healthcare to its neediest residents cannot discriminate against those residents who need care the most."

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