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July 28, 2008

Qui Tam litigation:Amerigroup Settles

Analysis of: Amerigroup OKs $225 Million Settlement | www.boston.com
This analysis is solely the work of the author. It has not been edited or endorsed by GLG.
Analysis By:
Martin Alpert, Claim DirectorMartin Alpert
Claim Director, CAMBRIDGE INTEGRATED SERVICES GROUP INC
Implications: How will this settlement affect Amerigroup's business opportunities in Illinois & other states?Will a settlement of this nature confirm the momentum of the Federal government in other similar whistleblower cases?

Analysis: Amerigroup took a fairly hard line stance when this whole litigation started that its practices were appropriate.  Despite this stance the federal court ordered them to pay 334 million in 2007 & Amerigroup nonetheless continued to pursue vindication in what have been the largest ever false claims case.  http://www.medicalnewstoday.com/articles/115959.php 
The evidence they allegedly discriminated against pregnant women & other high risk patients seemed more than just circumstantial.  Not surprisingly, with rising litigation costs they have decided to buy peace for about 2/3 of the initial judgement.  While Amerigroup cites many tax benefits & short term savings will result from this compromise, one seriously wonders how this settlement will affect their credibility not only in Illinois but in the ten plus other states that comprise most of their business.  One is not suggesting that this short term resolution was not cost effective, but some wonder whether it was penny wise & dollar foolish.  Amerigroup has clearly provided many healthcare benefits to many people, but one would only need to surmise that they may be under a microscope for many years to come.  This resolution will also will also likely fuel & confirm the charge by the federal government to not only go after other companies, but to keep at least one eye open relative to Amerigroup in other States! 


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