Neighborhood Diabetes, Inc. agreed to a settlement of more than $1.5 million with Massachusetts Attorney General Maura Healey on Friday over allegations that it billed and received improper Medicaid payments.
The Billerica-based pharmacy allegedly would refill prescriptions using its automatic refill program and charge the commonwealth's Medicaid program, despite not receiving orders for any prescriptions from caregivers, patients or the MassHealth hospital system.
Massachusetts' laws prohibit auto refill programs for prescriptions to MassHealth patients.
“We allege this pharmacy’s improper billing and refill practices resulted in unnecessary overpayments by MassHealth,” Healey said. “Our office is pleased that this resolution will provide restitution and requires compliance with state regulations.”
In addition to the monetary settlement, the pharmacy will also work to change its programs, so that there isn’t automatic refills or billing without specific requests from a MassHealth caregiver or patients. The company must also no longer provide prescriptions to patients who can’t pay the copayment.
This is the second settlement that Healey's office has reached with a pharmacy that was allegedly offering an automatic refill program to MassHealth patients. AllCare Pharmacy in Worcester, Massachusetts, agreed to a $1.6 million settlement in September 2013.