Eli Lilly filed a federal civil suit on Tuesday alleging that a coordinated rebate fraud scheme defrauded the company of more than $200 million in Trulicity refunds. The complaint outlines how claims were submitted for rebates on prescriptions that were never dispensed or were misrepresented to maximize refunds.

The lawsuit names several bishops and a high-ranking leader of the Church of God in Christ, accusing them and affiliated third parties of orchestrating the fraudulent submissions. It details communications and transactions that prosecutors say connect the church network to the rebate requests.

The alleged $200 million loss represents a material hit to Eli Lilly’s rebate expense line and could trigger restatements or reserve adjustments if further instances are uncovered. Management has indicated it will pursue full recovery and tighten rebate verification processes across its portfolio.

Eli Lilly is seeking both damages and injunctive relief, with potential criminal referrals and regulatory scrutiny possible if evidence supports broader misconduct. The case may set precedents for how drugmakers police rebate programs and could prompt industrywide compliance reviews.