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Health insurer to pay $5 million to settle charges over claims

Posted on December 1, 2021

Health insurers that have been embroiled in the Trump administration’s opioid crisis will pay more than $5.5 million in penalties and fines as part of a settlement reached with the Department of Justice, according to a federal court filing Friday.

In a settlement with the Office of the Inspector General, the American Medical Association and other insurers agreed to pay a total of $7 million to avoid an additional $5 billion in penalties in the future, according the complaint filed in federal court in Brooklyn.

The penalties include $1.9 million to the AMA for “the unlawful and illegal misrepresentations and misleading statements made in the public relations campaign against American Medical Devices, Inc., as well as the failure to correct the false representations and misleading information,” the DOJ said in a statement.

The OIG said in its complaint that the AMA and other companies misled the public by misrepresenting that opioid prescribing was not widespread in the United States.

In fact, the OIG alleged, opioids are prescribed at a higher rate than other drugs prescribed by doctors.

“This lawsuit was filed to provide relief for the health care system that was harmed by the misrepresentations, misleading statements, and the illegal use of opioids,” the OIA said.

“The OIA’s investigation is ongoing and the OIC is committed to vigorously enforcing the law.”

A spokeswoman for the AMA said in an email that it was pleased with the settlement.

“Our policy on prescribing opioids was to recommend patients use pain relievers only as prescribed, not to prescribe opioids for themselves,” the spokeswoman said.

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