Pharma

Walgreens pays $107 million to settle Rx fraud allegation

The retail pharmacy giant has paid up for billing government health programs for prescriptions that never existed.
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Ever wonder what happened to that Walgreens prescription you never picked up? If you have government-funded insurance, your health program might have covered the bill.

The US government alleges that the Illinois-based retail pharmacy chain submitted claims to Medicare, Medicaid, and other federal health programs for prescriptions it processed but were never collected by customers from 2009 to 2020, according to a September 13 release from the US Department of Justice (DOJ).

Walgreens has agreed to pay $106.8 million to settle the allegations.

The deets. Walgreens was specifically accused of violating the False Claims Act, an 1863 law that states that anyone who “knowingly submits” false claims to the government is liable for 3x the amount of damages, plus an additional penalty.

This allegation came after a disclosure in January 2020, when Walgreens self-reported to the US government that “issues with its billing systems and practices” had led it to bill federal health programs for prescriptions customers hadn’t picked up, according to the settlement agreement. (If customers never pick up their prescriptions, Walgreens isn’t supposed to get paid.)

“This settlement marks another major achievement in our ongoing commitment to combat healthcare fraud,” US Attorney for the Middle District of Florida Roger Handberg said. “It is essential to hold pharmacies accountable when they knowingly fail to abide by the rules and requirements of our national health care programs.”

Walgreens cooperated in the government’s investigation, updated its billing system to fix the problem, and had previously refunded the programs $66,314,790, according to the settlement.

In total, the federal government will receive $91,881,530 and Medicaid-participating states will get a total of $14,933,259. Walgreens’s $66 million refund will be subtracted from its debt, according to the DOJ release.

Navigate the healthcare industry

Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.

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