In a significant move for healthcare accountability, Massachusetts Attorney General Andrea Joy Campbell announced today that MassHealth has been awarded $1.4 million as part of a $47 million national settlement with QOL Medical, LLC, and its chief executive, Frederick E. Cooper. According to a press release from the Attorney General's Office, the legal action was in response to allegations that QOL Medical engaged in unlawful kickback activities to boost sales of its enzyme replacement medicine, Sucraid.

Joining forces with the U.S. government and 17 other states, Massachusetts pursued this case as part of its mission to protect public funds, with AG Campbell stating, "Paying kickbacks to generate healthcare profits is unlawful," and emphasizing the importance of safeguarding the resources that support MassHealth, which provides critical healthcare for thousands of its residents. Assistant Secretary of Health and Human Services and Medicaid Director Mike Levine, in appreciation for the Attorney General's Medicaid Fraud Division, voiced his gratitude, "MassHealth is grateful for the hard work of the Attorney General's Medicaid Fraud Division," acknowledging their role in defending taxpayer dollars, as reported by the Attorney General's Office.

The privately owned Florida company QOL Medical faced accusations of employing a strategy aimed at influencing patients to purchase Sucraid, which included the distribution of free Carbon-13 tests to diagnose Congenital Sucrase Isomaltase Deficiency (CSID), subsequently compensating a clinical laboratory to assess those tests and targeting the resulting patients' healthcare providers with sales calls. The settlement explicitly admits the practice by QOL, elucidating their method to potentially manipulate medication sales.

As delineated in the Massachusetts settlement, the actions of QOL and Cooper purportedly resulted in fraudulent claims to MassHealth by way of inducements to the clinical lab for test result data, coupled with kickbacks to MassHealth members in the form of cost-free tests aimed to sway their buying decisions favoring Sucraid, reimbursed by Medicaid. The whistleblower lawsuit that triggered this settlement was initially filed in the United States District Court for the District of Massachusetts, and a team from the National Association of Medicaid Fraud Control Units, featuring representatives from AG Campbell’s Medicaid Fraud Division, took the helm during negotiations.

The Massachusetts AGO's Medicaid Fraud Division holds an annual certification from the U.S. Department of Health and Human Services to investigate and prosecute healthcare providers who defraud the state's Medicaid program. The division is also tasked with tackling cases of abuse, neglect, and financial exploitation within long-term care facilities and among Medicaid patients in various healthcare settings. For the federal fiscal year 2025, the U.S. Department of Health and Human Services funded 75% of the division's operations, amounting to $5,922,320, while the Commonwealth of Massachusetts covered the remaining 25%, which totaled $1,974,102.