Gilead Pays Texas $45 Million to Settle Medicaid Kickback Claims

Drugmaker Gilead Sciences will pay $45 million to settle Texas claims that it used free nursing and paperwork services to steer doctors toward prescribing its drugs to Texas Medicaid patients, the Texas attorney general’s office announced on October 22.

The settlement ends a whistleblower lawsuit in Harrison County that the state pursued starting in October 2023, according to the release and the settlement agreement. Gilead denies the allegations.

“Doctors ought to prescribe medication in accordance with what is in the best interest of the patient,” Attorney General Ken Paxton said. “When Big Pharma attempts to bribe providers by offering kickbacks, the integrity of our healthcare system is jeopardized.”

What Texas alleged

The state accused Gilead of offering illegal incentives to Texas providers through two programs, which the agreement describes. One was a “Free Nurse Program,” the “offer and/or provision of free nursing services and education to prescribers and patients as in-kind remuneration.” The other was a “Support Services Program,” the “assumption of reimbursement and administrative support services that prescribers are duty-bound to perform for their patients.”

Texas said the programs violated the Texas Health Care Program Fraud Prevention Act and the state’s anti-kickback law. The drugs covered by the settlement include Gilead’s HIV, hepatitis B and hepatitis C medicines, among them Biktarvy, Descovy, Truvada and Harvoni.

The case was filed by a whistleblower company, Health Choice Advocates LLC, and is styled The State of Texas ex rel. Health Choice Advocates, LLC v. Gilead Sciences, Inc.

Where the money goes

Of the $45 million, $24,562,500 is restitution, the agreement says. The total includes the state’s attorney’s fees and costs and part of the whistleblower’s fees. Because Medicaid is paid for partly with federal money, Texas will send the federal government its share. The whistleblower’s own share is paid separately under an agreement that was not made public.

Gilead “has denied and continues to deny” the allegations, and the agreement is “neither an admission of facts, wrongdoing, fault” nor of liability, the document says. Once Gilead pays, the state and the whistleblower will drop the case for good.

An earlier federal case

In April 2025, Gilead agreed to pay $202 million to resolve a separate federal case in New York over paid speaker programs for doctors, according to the U.S. Department of Health and Human Services’ Office of Inspector General. That case covered different conduct.

Paxton’s office has brought similar Medicaid cases against other drugmakers, including AstraZeneca, the release says.