Insurance company Amerigroup Corp. announced Tuesday it has agreed in principle to settle a lawsuit accusing it of discriminating against pregnant women and other high-risk patients for $234 million.
The settlement includes $225 million to be paid to the federal government and the state of Illinois plus $9 million in legal fees, the company said in a statement issued from its Virginia Beach, Va., offices.
A federal judge in Chicago in 2007 ordered the company to pay $334 million plus fees after a jury found it avoided pregnant women and others while receiving Medicaid money designed to assure services to them through the Illinois Department of Public Aid (IDPA).
Amerigroup said it would admit no wrongdoing under the settlement.
"We are concluding this litigation now to remove a source of significant legal and financial uncertainty for our organization," said James G. Carlson, Amerigroup's chairman and chief executive officer.
"With this matter resolved we can concentrate fully on the business at hand - meeting the health care needs of our members and continuing to serve our government partners," Carlson said. It would be best "to close this chapter now and move toward the future," he said.
The case was before the 7th U.S. Circuit Court of Appeals in Chicago when the settlement talks got under way.
The dispute began with a so-called whistleblower lawsuit filed by Cleveland Tyson, a former lobbyist for Amerigroup's Illinois subsidiary. The federal government later joined the lawsuit.
Under federal whistleblower law, Tyson stands to collect 15 percent to 25 percent of the final judgment in the case.
Tyson attorneys David Chizewer and Fred Cohen issued a statement praising the whistleblower process as a means to curb corporate abuses.
"Amerigroup pocketed IDPA money while leaving pregnant women to fend for themselves," Cohen said.
Samuel B. Cole, an assistant U.S. attorney who represented the government, declined to comment.
Illinois Attorney General Lisa Madigan said in a statement that "our goal has been to send a clear message that the state of Illinois will not tolerate interference with the health and well being of Illinoisans."
Amerigroup said in its statement that the company would reap a $35 million tax benefit from the settlement and take a one-time charge of $199 million in the second quarter that ended June 30.
It said the company will pay the settlement from restricted funds previously established to cover costs related to the judgment. After the payment, which is expected to occur in the third quarter, the company's unrestricted cash balance will increase by approximately $117 million due to the release of the remainder of the restricted funds.
Under the program, Amerigroup had a contract with the state of Illinois to provide services for needy patients and in return received Medicaid money designed to make certain all patients received services.
Witnesses at the trial before U.S. District Judge Harry D. Leinenweber said the company found ways of keeping pregnant women out of the program because they were at risk of requiring expensive treatment.
Company officials have repeatedly denied the allegations.
Amerigroup ended its contract with the state in 2006. It said that decision was unrelated to the lawsuit.
The 13-year-old company reported $3.9 billion in revenues in 2007 and provides services to 1.7 million people in Florida, Georgia, Maryland, New Jersey, New Mexico, New York, Ohio, South Carolina, Tennessee, Texas and Virginia.
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