Amerigroup Corporation has agreed to pay $225 million to resolve claims that it defrauded the Illinois Medicaid program, according the the US Department of Justice.
A federal jury and judge found that Amerigroup systematically avoided enrolling pregnant
women and other high-risk patients in their managed care program in Illinois. Amerigroup, which is based in Virginia Beach, Virginia, operates managed health care plans nationwide. Amerigroup is a care management organization, or CMO, in Georgia, which means it helps manage the medical care of Georgia’s Medicaid and PeachCare members.
In 2005, the United States and the State of Illinois joined a lawsuit against Amerigroup,
alleging that it violated federal program requirements by avoiding enrolling unhealthy patients, as well as pregnant women, who were more costly to treat and would have eroded Amerigroup’s profit margin.
Amerigroup states the settlement is not an admission of liability. Rather, the agreement states that the parties settled to avoid the delay, uncertainty and expense of further litigation.
To learn more, click the link below to watch a story about the settlement from ABC News.
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