Eli Lilly Loses $184M Medicaid Fraud Appeal in US Court

Eli Lilly has been ordered by the US Court of Appeals for the Seventh Circuit to pay over $183 million in damages for defrauding Medicaid by underreporting drug rebate prices. The ruling upheld a decade-long whistleblower lawsuit initiated by Ronald Streck, which found that Lilly engaged in a scheme where it charged wholesalers higher prices retroactively but reported lower average manufacturer prices (AMP) to the government, resulting in underpayments exceeding $61 million. Circuit Judge Joshua Kolar emphasized that Lilly knowingly misled Medicaid and disregarded legal risks by using an overcomplicated pricing interpretation instead of a common-sense reading of the law. The court rejected Lilly's appeal arguments, affirming the jury's finding of false AMP calculations and culpability. Lilly stated its disagreement with the decision and plans to appeal further, noting inconsistencies with other rulings in related cases. Similar whistleblower cases against other pharmaceutical companies have resulted in substantial settlement payments, underscoring ongoing scrutiny of drugmakers' Medicaid rebate practices.