Gilead Sciences will pay Texas $45 million to settle a lawsuit accusing the drugmaker of using free nursing services and insurance paperwork help to win prescriptions paid for by the state's Medicaid program, Attorney General Ken Paxton's office announced Thursday.
The case, The State of Texas ex rel. Health Choice Advocates, LLC v. Gilead Sciences, Inc., is in Harrison County District Court, where the attorney general's office says it sued in October 2023. The agreement says the case was started by Health Choice Advocates, which it calls the relator, with the state as a co-plaintiff.
The suit claimed that two Gilead programs amounted to illegal payments under the Texas Health Care Program Fraud Prevention Act and the state's anti-kickback law: one that offered nurses and education to prescribers and patients at no charge, and one in which the company took over reimbursement and administrative work that the suit said doctors' offices should handle themselves.
Both sides
In the attorney general's announcement, Paxton said doctors should prescribe based on a patient's best interest and that kickbacks put the integrity of the health care system at risk. His office said many of the affected prescriptions were billed to Medicaid.
The settlement agreement, posted with the announcement, states that it is a compromise of disputed facts and is not an admission of wrongdoing or liability by Gilead. It says the company has denied and continues to deny the allegations, including the names the state gave its programs, and that it maintains it has defenses to the claims.
It says that denial also extends to the company's ongoing patient support programs.
