JEFFERSON CITY, Mo. (Legal Newsline) - Missouri Attorney General Chris Koster announced on Tuesday that his office has reached a settlement with a St. Louis pharmacy over Medicaid billing practices.
Koster's Medicaid Fraud Control Unit alleged that Christopher Geronsin, Inc., doing business as Beverly Hills Pharmacy, helped as many as 200 Medicaid recipients meet their spend-down requirements and then improperly submitted claims to Medicaid for reimbursement. These same claims were also allegedly submitted to the Missouri Division of Family Services to meet one Medicaid recipient's spend-down amounts and knowingly contained incorrect dates of services.
Medicaid provides medical services to individuals with an income below 85 percent of the federal poverty level. Those above that limit must incur medical expenses equal to the amount their income exceeds that limit to qualify. Regulations of Medicaid prohibit reimbursement for items used to meet an individual's spend-down amount. The unit alleged that Beverly Hills Pharmacy's actions resulted in billing for services that were not allowed to receive payment.
The agreement requires Beverly Hills Pharmacy to pay $235,060 in restitution, $235,060 in damages, a $25,000 civil penalty and $4,880 in legal costs, for a total of $500,000.
Beverly Hills Pharmacy also agreed to comply with all Medicaid regulations and rules, inklings all spend-down requirements from and after the date of the agreement.
Beverly Hills Pharmacy is not required to admit to any liability as part of the agreement.
"One of my top priorities as attorney general is to pursue, prosecute, penalize and prevent fraud and abuse of Missouri's Medicaid Health Care System," Koster said. "We will continue to search for companies and individuals who engage in this behavior and recover the monies rightfully belonging to the people of Missouri."