Penalty Amount
$1,000,000
The Connecticut Attorney General settled with PCA Pain Care Center and its owner for overbilling Medicaid by using higher billing codes than warranted for services provided. They paid $1 million to resolve allegations under the Connecticut False Claims Act.
PCA and Robinson paid $1 million and an additional $45,000 to offset future audit expenses, and agreed to post-settlement monitoring of billing practices.
In-house legal teams should review all provider-payor agreements, including Medicaid managed care contracts, commercial insurer participation agreements, and any third-party administrator (TPA) arrangements. Focus on clauses governing billing and coding compliance, representations and warranties regarding claim accuracy, indemnification for false claims, audit rights, and termination for regulatory violations. Specific attention is needed for provisions that incorporate by reference payer billing manuals, CPT coding guidelines, and state/federal healthcare program rules. Changes may be required to add mandatory coder training certifications, implement pre-submission coding review protocols, strengthen audit cooperation terms, and clarify liability for overpayments resulting from upcoding or misrepresentation of service levels.
Entity
Robinson PA, LLC d/b/a PCA Pain Care Center
Also known as: PCA Pain Care Center
Industry
Healthcare$29.6M
Attorney General Jennifer Davenport joined a coalition of 48 states and territories in a $29.6 million settlement with Glenmark, a generic drug manufacturer, for allegedly conspiring to artificially inflate and manipulate prices, reduce competition, and restrain trade for numerous generic prescription drugs. The settlement includes cooperation in ongoing litigations and internal reforms to ensure fair competition.
$29.6M
Attorney General William Tong led a coalition of 48 states and territories in a $29.6 million settlement with Glenmark, a generic drug manufacturer, to resolve allegations of a widespread conspiracy to artificially inflate prices, reduce competition, and unreasonably restrain trade for numerous generic prescription drugs. The settlement includes cooperation from Glenmark in ongoing multistate litigations and internal reforms to ensure fair competition and compliance with antitrust laws.
$18.0M
Attorney General William Tong led a coalition of 42 attorneys general in a settlement with the bankruptcy trustee for 23andMe, resolving allegations from a 2023 data breach that compromised the genetic data of 6.9 million customers. The settlement includes $150 million in allowed claims, with $18 million paid from bankruptcy funds, and requires enhanced data security measures for the new entity holding the data.
Attorney General William Tong joined a coalition of 12 attorneys general in suing to block the $110 billion acquisition of Warner Bros. Discovery, Inc. by Paramount Skydance Corporation. The lawsuit alleges the merger violates Section 7 of the Clayton Act by substantially lessening competition in theatrical film distribution and basic cable television licensing, which would harm consumers through higher prices and reduced quality.
Attorney General William Tong and 48 other attorneys general submitted comments to the FCC urging stronger rules to prevent scammers from accessing legitimate telephone numbers for illegal robocalls. The coalition is responding to the FCC's proposed rules and asks for measures such as stronger certification, reporting, and prohibitions on number cycling.
$45.0M
Attorney General Tong announced a $45 million multistate settlement with Block, Inc., the company behind Cash App, for misleading consumers about the safety of the platform, failing to protect users from fraud, and not providing promised fraud protection and resolution services. The settlement requires Block to implement major reforms including real customer support, transparent communications, and security commitments, and reaffirms Block's commitment to distribute between $75 million and $120 million to compensate consumers as part of a separate CFPB settlement.