Texas AG Secures Nearly $34 Million Settlement with Pharmaceutical Company, Reinforcing Active Ongoing THFPA Enforcement

The Texas Attorney General (“Texas AG”) recently announced a settlement with AstraZeneca Pharmaceuticals LP (“AstraZeneca”) for $33,998,000 to resolve allegations under the Texas Health Care Program Fraud Prevention Act (“THFPA”) arising from the company’s nurse educator program and nurse and patient support programs. See State ex rel. SCEF, LLC v. AstraZeneca Pharmaceuticals LP, No. D-1-GN-25-011002 (250th Dist. Ct., Travis County, transferred Dec. 18, 2025). This settlement is the latest in a series of actions by the Texas AG that demonstrate the office’s focus on large healthcare corporations and aggressive deployment of the THFPA, as discussed here.

The settlement arises from claims brought by Relators, including SCEF, LLC, a New Jersey-based entity formed to bring qui tam actions, asserting that AstraZeneca used three types of programs to induce prescriptions reimbursed by Texas Medicaid in alleged violation of the Texas Anti-Kickback Statute (“TAKS”) and the THFPA: (1) a “White Coat Marketing Program”; (2) free “Nurse Support Services”; and (3) a “Support Services Program.”

• White Coat Marketing. Relators and the Texas AG alleged that AstraZeneca “contracted with and paid remuneration to” third-party vendors to deploy nurses and other healthcare professionals to promote AstraZeneca’s products to providers. Relators and the Texas AG alleged that while these individuals were labeled educators, they received sales training, targeted prescribers “with high potential to prescribe [AstraZeneca’s] drugs,” and were compensated based in part on sales-related metrics. Accordingly, Relators and the Texas AG claimed that AstraZeneca’s relationship with third-party nurse providers violated the TAKS and the THFPA.
• Nurse Support Services. Relators and the Texas AG also alleged that AstraZeneca offered providers free nurse support services for patients prescribed certain AstraZeneca products, which Relators and the Texas AG claim constituted prohibited remuneration in violation of the TAKS. These services included: “(i) assisting Prescribers to increase practice efficiency; (ii) training on disease care; (iii) eliminating the administrative expense to Prescribers of having to educate patients; and (iv) being on call to answer patients’ questions.”
• Support Services. Finally, Relators and the Texas AG alleged that AstraZeneca provided prohibited remuneration to providers through its Access 360 program, which allegedly included benefit verification, prior authorization assistance, coverage determination, and appeals assistance.

The THFPA enforcement landscape remains unsettled, making compliance difficult and providing opportunities for the Texas AG (and opportunistic Relators and their counsel) to exploit expansive interpretations of the THFPA and TAKS. As Texas continues to expand its healthcare fraud enforcement efforts, companies should promptly evaluate patient support programs, reimbursement assistance programs, field-based clinical personnel operations, and similar programs for compliance.

A copy of the settlement agreement is available here, and a copy of the petition can be found here.

This post is as of the posting date stated above. Sidley Austin LLP assumes no duty to update this post or post about any subsequent developments having a bearing on this post.