The allegations involve claims for prescriptions that were processed but never dispensed, spanning a period from 2009 to 2020. This settlement resolution falls under the False Claims Act, a tool for addressing fraud involving taxpayer-funded health care programs.
The DOJ alleged that Walgreens billed federal health care programs for prescriptions that beneficiaries never picked up, allowing the company to receive millions of dollars in payments for medications that were never provided.
Walgreens, which is based in Deerfield, Illinois, did not admit liability in agreeing to settle.
“Due to a software error, we inadvertently billed some government health care programs for a relatively small number of prescriptions our patients submitted but never picked up,” the company said in an emailed statement to The Epoch Times.
“We corrected the error, reported the issue to the government, and voluntarily refunded all overpayments. We appreciate the government acknowledged our compliance efforts as part of resolving this matter.”
U.S. Attorney Alexander Uballez for the District of New Mexico said such fraudulent billing practices compromise the integrity of vital federal programs.
“Millions of Americans rely on the promise of federal health care through programs like Medicare and Medicaid,” said Uballez. “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.”
The DOJ said Walgreens has already taken steps to address the issue by enhancing its electronic pharmacy management system to prevent future occurrences of unaccounted-for prescription claims.
The company also self-reported certain aspects of its conduct during the investigation, according to the DOJ press release. As a result of its cooperation, Walgreens received credit for $66,314,790, which it previously refunded to federal health care programs, according to the DOJ.
The federal government’s share of the settlement is $91,881,530, while $14,933,259 will be returned to individual states that jointly fund Medicaid programs.
The settlement resolves three whistleblower cases, also known as “qui tam” actions, filed under the False Claims Act. These cases were pursued in the District of New Mexico, the Eastern District of Texas, and the Middle District of Florida.
One of the whistleblowers, Steven Turck, a former Walgreens pharmacy manager, filed a lawsuit in the Eastern District of Texas, leading to significant revelations about Walgreens’ billing practices.
Turck will receive $14,918,675 as part of the settlement, according to the agreement filed in federal court.
Another whistleblower, Andrew Bustos, a former district pharmacy supervisor, filed a separate suit in the District of New Mexico, leading to his award of $1,620,000 for exposing similar fraudulent activities.
“Medicare enrollees, and consumers at large, rely on pharmacies for critical medications that sustain their quality of life, and providers who prey upon public health care programs to increase profit margins must be held accountable,” said Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General.
