Date: 11-02-2006

Case Style: Cleveland Tyson, et al. v. Americgroup, Illinois, Inc., et al.

Case Number: 1:02-cv-06074

Judge: Harry D. Leinenweber

Court: United States District Court for the Northern District of Illinois, Cook County

Plaintiff's Attorney:

David Jamison Adams, Tyree L Givens, John E. Huston, Joan Matlack, Anne Renee Kuper Reader, Abel Leon, and Paul Joseph Gaynor, Illinois Attorney General's Office, Chicago, Illinois

Michael I Behn of Behn & Wyetzner, Chartered, Chicago, Illinois

Chad A Blumenfield, Ann H Chen and Katharine Emily Burdic, Frederick H. Cohen, Hillary Levitt Dunn, Karen Elaine Konieczny, Maureen Elizabeth Merin, Clare M. Pinkert, Marla Helene Swartz, and David Joel Chizewer of Goldberg, Kohn, Bell, Black, Rosenbloom & Moritz, Ltd., Chicago, Illinois

Samuel B. Cole, Patrick Walter Johnson, and Michele Marion Fox, United States Attorney's Office, Northern District of Illinois, Chicago, Illinois

Michael Keyes Hendershot of Brinks, Hofer, Gilson & Lione, Chicago, Illinois

Michael Charles Rosenblat of Michael E. Rosenblat, P.C., Glenview, Illinois

William W Thomas of Futterman & Howard, Chtd., Chicago, Illinois

Defendant's Attorney:

Gia Fonte Colunga, Jeffrey Lawrence Dorman, Kellye L Fabian, Catherine A. Miller, Andrew C. Nordahl, Hillard M. Sterling, Daniel John Voelker, Garry L Wills and Daniel Charles Curth of Freeborn & Peters, Chicago, Illinois

Daniel J. Riley and Robert J. Wagman, Jr. of Baker Botts LLP, Washington, D.C.

Joel Aaron Brodsky and Brendan George O'Connor of Quarles & Brady LLP, Chicago, Illinois of United Health Care of Illinois, Inc.

Edwin Earl Brooks of Gardner Carton & Douglas LLP, Chicago, Illinois for Harmony Health Plan of Illinois, Inc.

William A. Chittenden, III and Georgia Lynne Joyce of Chittenden, Murday & Novotny, LLC, Chicago, Illinois

Thomas F Ging and Clay M. Ullrick of Hinshaw & Culbertson LLP, Chicago, Illinois

David William Porteous of Levenfeld Pearlstein, LLC, Chicago, Illinois

Description:

Illinois Attorney General Lisa Madigan and United States Attorney Patrick J. Fitzgerald today announced a federal jury returned a $48 million dollar verdict against Amerigroup Illinois and Amerigroup Corporation. The jury found both companies liable for systematic and extensive fraud in the Medicaid program, which is funded jointly by the federal and state governments.

From 2000-2004 Amerigroup was paid $243 million to set up a Medicaid managed care health plan in Illinois that would help low income people get the care they need. Amerigroup was paid, in part, to help low income pregnant women who had inadequate prenatal care to navigate the complicated healthcare system and find care. Amerigroup spent less than half of the funds they were paid by the state and federal governments on providing healthcare. In accordance with federal law and its contract with the State, Amerigroup was required to market to all eligible Medicaid beneficiaries and was prohibited from discriminating on the basis of health status or need for health services.

Outcome: The amount of the jury award will be tripled under the federal False Claims Act and the Illinois Whistleblower Reward and Protection Act for a total damage award of $144 million. Additionally, under the law, Attorney General Madigan and U.S. Attorney Fitzgerald will ask the court to impose penalties, ranging from $5,500 to $11,000 for each of the 18,130 false claims that the juries found were submitted by Amerigroup. The verdict amounts to one of the largest ever fraud jury verdicts against a Medicaid contractor.

Plaintiff's Experts: Unknown

Defendant's Experts: Unknown

Comments: None