Attorney General Ken Paxton’s Healthcare Program Enforcement Division has secured $40 million for the State of Texas by settling an enforcement action brought under the Texas Health Care Program Fraud Prevention Act (“THFPA”) against Molina Healthcare of Texas, Inc. and Molina Healthcare, Inc. (together, “Molina”).
Molina—a publicly traded Fortune 500 health care organization—serves Texans who are members of the Medicaid STAR+PLUS program, which is designed to aid individuals who are disabled, blind, or aged 65 and older.
This settlement resolves allegations that Molina failed to timely assess Medicaid beneficiaries for services required under the program and concealed its non-compliance from Texas. The alleged violations of the THFPA were brought in a lawsuit filed by a whistleblower under the qui tam provisions of that statute.
“This $40 million payment to Texas helps ensure that managed care organizations who contract with Texas Medicaid are held to the highest standards,” said Attorney General Paxton. “I will continue to defend our health programs against fraud and take action against any bad actors who falsely believe that they can take advantage of our state’s health system and the Texans who depend on it.”