To prevent future occurrences, Walgreens has made improvements to its electronic pharmacy management system and has self-reported certain actions. Additionally, since Walgreens had already refunded $66,314,790 related to the claims in question, it will receive a credit for that amount.
Walgreens Boots Alliance Inc. and Walgreen Co. have reached an agreement to pay $106.8 million to settle allegations of violating the False Claims Act and various state laws by billing government health care programs for prescriptions that were never actually dispensed. Based in Deerfield, Illinois, Walgreens is one of the largest retail pharmacy chains in the United States.
The government claims that from 2009 to 2020, Walgreens submitted inaccurate payment requests to Medicare, Medicaid, and other federal health care programs for prescriptions that were processed but never collected by patients. Consequently, Walgreens received tens of millions of dollars for prescriptions that were not provided to health care beneficiaries.
“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. We are committed to guarding the public’s investment in our health from private corporations.”
As part of the settlement, Walgreens was credited for its disclosure, cooperation, and remediation efforts in accordance with the department’s guidelines for False Claims Act cases. To prevent future occurrences, Walgreens has made improvements to its electronic pharmacy management system and has self-reported certain actions. Additionally, since Walgreens had already refunded $66,314,790 related to the claims in question, it will receive a credit for that amount.
“Adopting new technology and systems can be beneficial for providers, beneficiaries, and federal payors, 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 health care programs for goods and services never provided to beneficiaries. In those situations, we will pursue the companies and ensure that the taxpayer is made whole.”
The federal contribution to the recovery amounts to $91,881,530, with an additional $14,933,259 allocated to individual states. This funding will support state Medicaid programs through distinct settlement agreements with the states involved in the Medicaid program.
In a significant settlement with Walgreens, the federal government has resolved three ongoing cases in the District of New Mexico, Eastern District of Texas, and Middle District of Florida. These cases were brought under the qui tam provision of the False Claims Act, which allows private individuals to sue for false claims on behalf of the United States and receive a portion of the recovery.
Steven Turck, a former pharmacy manager at Walgreens, initiated a qui tam lawsuit in the Eastern District of Texas concerning improper billing to Medicare, Medicaid, and other federal health care programs, and he is set to receive $14,918,675. Meanwhile, Andrew Bustos, a former district pharmacy supervisor at Walgreens, filed a qui tam suit in the District of New Mexico regarding billing for Medicare Part B, and he will receive $1,620,000.
“This settlement marks another major achievement in our ongoing commitment to combat healthcare fraud,” said U.S. Attorney Roger B. Handberg for the Middle District of Florida. “It is essential to hold pharmacies accountable when they knowingly fail to abide by the rules and requirements of our national health care programs.”
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