Press Release: 2025-02-04
AG Campbell Secures $1.4 Million for MassHealth Over Kickback Allegations Against National Pharmaceutical Company
U.S. and 18 States Receive $47 Million From QOL Medical to Resolve Alleged Kickback Violations
FOR IMMEDIATE RELEASE:
2/03/2025
MEDIA CONTACT
Sabrina Zafar , Deputy Press Secretary
Phone
Call Sabrina Zafar , Deputy Press Secretary at (617) 727-2543
Online
Email Sabrina Zafar , Deputy Press Secretary at Sabrina.Zafar2@mass.gov
BOSTON — Attorney General Andrea Joy Campbell has today announced that the Massachusetts Medicaid program, MassHealth, received $1.4 million as part of a $47 million national settlement with pharmaceutical manufacturer QOL Medical, LLC (“QOL”) and its CEO, Frederick E. Cooper. The settlement resolves allegations that the company made unlawful payments to a clinical laboratory to induce the purchase of its enzyme replacement therapy, Sucraid, in violation of the Anti-Kickback Statute and False Claims Act.
Massachusetts was joined by the U.S. government and 17 other states in reaching the settlement.
“Paying kickbacks to generate healthcare profits is unlawful,” said AG Campbell. “We will continue to protect crucial taxpayer-funded resources and meaningfully return resources to our MassHealth program relied on by thousands of residents for their healthcare needs.”
"MassHealth is grateful for the hard work of the Attorney General's Medicaid Fraud Division," said Assistant Secretary of Health and Human Services and Medicaid Director Mike Levine. “We appreciate their dedication to ensuring that taxpayer dollars are protected."
QOL is a Florida-based privately held company that sells enzyme replacement therapies, including Sucraid (sacrosidase), for patients with rare diseases.
Under the settlement, QOL admitted to engaging in a scheme to influence patients to purchase Sucraid. QOL’s scheme involved distributing free Carbon-13 tests to health care providers to help diagnose Congenital Sucrase Isomaltase Deficiency (“CSID”), a condition for which Sucraid is the only FDA-approved therapy. QOL then paid a clinical laboratory to analyze patients’ Carbon-13 tests to receive data identifying patients who tested positive. QOL then contacted those patients’ health care providers to make sales calls.
The Massachusetts settlement alleges that, by engaging in this conduct, QOL and Cooper caused the submission of false claims to MassHealth by paying kickbacks to the clinical laboratory to induce it to provide the test results data to QOL, along with paying kickbacks to MassHealth members by covering the cost of free tests to ultimately induce their purchase of Sucraid reimbursed by Medicaid.
This settlement results from a whistleblower lawsuit originally filed in the United States District Court for the District of Massachusetts. A team from the National Association of Medicaid Fraud Control Units (NAMFCU) participated in the settlement negotiations on behalf of the states.
The NAMFCU team included representatives from AG Campbell’s Medicaid Fraud Division (MFD). MFD’s Managing Attorney Ian Marinoff served as the team’s lead attorney and MFD’s Senior Healthcare Fraud Investigator William Welsh served as the team’s lead analyst.
The AGO’s Medicaid Fraud Division is a Medicaid Fraud Control Unit, annually certified by the U.S. Department of Health and Human Services to investigate and prosecute health care providers who defraud the state’s Medicaid program, MassHealth. The Medicaid Fraud Division also has jurisdiction to investigate and prosecute complaints of abuse, neglect and financial exploitation of residents in long-term care facilities and of Medicaid patients in any health care setting. Individuals may file a MassHealth fraud complaint or report cases of abuse or neglect of Medicaid patients or long-term care residents by visiting the AGO’s website.
The Massachusetts Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,922,320 for federal fiscal year 2025. The remaining 25 percent, totaling $1,974,102 for FY 2025, is funded by the Commonwealth of Massachusetts.