Texas Secures $45 Million Settlement With Gilead Over Medicaid Kickback Claims

Texas Attorney General Ken Paxton (R) has secured a $45 million settlement with pharmaceutical manufacturer Gilead Sciences to resolve allegations that the company used improper incentives to influence prescriptions covered by Texas Medicaid.

The agreement follows a lawsuit filed by Paxton's office in October 2023 under the Texas Health Care Program Fraud Prevention Act.

The state alleges that Gilead offered medical providers benefits, including free nursing services and reimbursement support, to encourage prescriptions of its medications over competing drugs. According to the attorney general's office, some of those prescriptions were paid for through Medicaid, generating claims that Texas alleged were connected to the company's marketing practices.

Gilead agreed to pay $45 million to resolve the state's claims. The company denied Texas' fraud allegations and said it accepted the settlement to avoid the cost and distraction of prolonged litigation.

What did Paxton say about the settlement?

Paxton described the agreement as part of his office's efforts to protect public health care funds and deter pharmaceutical companies from using incentives that could influence prescribing decisions.

"Doctors ought to prescribe medication in accordance with what is in the best interest of the patient," said Paxton, warning that his office would continue pursuing companies accused of jeopardizing Texans' health or misusing taxpayer dollars.

Is Texas pursuing similar cases against other drugmakers?

The Gilead agreement follows a separate settlement with AstraZeneca announced in June 2026. Under that agreement, AstraZeneca agreed to pay nearly $34 million to resolve allegations involving free nursing services and reimbursement support provided to prescribers.

Paxton's office has also filed lawsuits against Eli Lilly and Sanofi-Aventis over alleged incentives provided to health care providers. Those actions are part of the state's broader efforts to pursue pharmaceutical companies over alleged violations involving Medicaid prescriptions.