Raising Women’s Voices

Amerigroup Settles Medicaid Lawsuit Over Denial of Coverage to Pregnant Women for $225M

Posted in Insurance companies, Pre-existing conditions by raisingwomensvoices on July 23, 2008

Amerigroup on Tuesday said it will enter a $225 million settlement agreement with Illinois and the federal government over allegations that it denied coverage to eligible pregnant women, the Baltimore Sun reports (Baltimore Sun, 7/23).

Cleveland Tyson, former vice president of government relations at Amerigroup’s Illinois subsidiary, in 2002 filed a whistle-blower lawsuit that claimed the company cherry-picked the healthiest patients to reduce spending. The U.S. attorney in Chicago and the Illinois attorney general later joined the lawsuit as plaintiffs. Illinois paid Amerigroup a flat fee per beneficiary that took into account that some people require more costly treatment than others. In March 2007, a federal judge in Chicago ruled against Amerigroup and awarded $334 million in the lawsuit.

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