Walgreens to pay $106.8 million to settle prescription billing claims
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Walgreens has agreed to pay $106.8 million to resolve allegations that it billed the government for prescriptions never dispensed, according to the Department of Justice.
The government alleges that, between 2009 and 2020, Walgreens submitted false claims for payment to Medicare, Medicaid and other federal healthcare programs for prescriptions that it processed but were never picked up by beneficiaries. As a result, Walgreens received tens of millions of dollars for prescriptions that it never actually provided, the DOJ said.
WHY THIS MATTERS
The federal settlement with Walgreens resolves three whistleblower cases brought in New Mexico, Texas and Florida, according to the DOJ.
As part of the resolution, Walgreens received credit for cooperation and remediation. Walgreens implemented enhancements to its electronic pharmacy management system to prevent future similar conduct.
“Adopting new technology and systems can be beneficial for providers, beneficiaries, and federal payers, including Medicare, Medicaid and TRICARE,” said U.S. Attorney Damien M. Diggs for the Eastern District of Texas. “However, we will not allow companies to hide behind their implementation of ill-conceived technology and systems that result in billing federal healthcare programs for goods and services never provided to beneficiaries.”
Walgreens previously refunded more than $66 million pertaining to the settled claims and will receive a credit for this amount, the DOJ said.
The federal share of the recovery is $91.9 million and a total of $14.9 million will be returned to individual states.
Pharmacies typically return uncollected prescriptions to stock and cancel the order after two to 14 days, according to SingleCare.
THE LARGER TREND
The civil settlements with Walgreens resolved several court cases, according to the DOJ.
Whistleblower Steven Turck, a former Walgreens pharmacy manager, filed the lawsuit in the Eastern District of Texas, and will receive $14.9 million.
Andrew Bustos, a former Walgreens district pharmacy supervisor, filed the whistleblower suit in the District of New Mexico and will receive $1.6 million.
Walgreens, headquartered in Deerfield, Illinois, operates one of the largest retail pharmacy chains in the country.
ON THE RECORD
“Millions of Americans rely on the promise of federal healthcare through programs like Medicare and Medicaid,” said U.S. Attorney Alexander M.M. Uballez for the District of New Mexico. “Fraudulently billing for prescriptions which are never dispensed endangers the integrity of these critical programs.”
Email the writer: SMorse@himss.org