Walgreens Boots Alliance Inc. and Walgreen Co. (collectively, Walgreens) have agreed to pay $106.8 million to resolve alleged violations of the False Claims Act and state statutes for billing government health care programs for prescriptions never dispensed. Walgreens, headquartered in Deerfield, Illinois, operates one of the largest retail pharmacy chains in the country.
The government alleges that between 2009 and 2020, Walgreens submitted false claims for payment to Medicare, Medicaid, and other federal health care programs for prescriptions that were processed but never picked up by beneficiaries. As a result, Walgreens received tens of millions of dollars for prescriptions that it never actually provided to health care beneficiaries.
As part of the resolution, Walgreens received credit under the department’s guidelines for taking disclosure, cooperation, and remediation into account in False Claims Act cases. Among other actions, Walgreens implemented enhancements to its electronic pharmacy management system to prevent this from occurring in the future and self-reported certain conduct. Because Walgreens previously refunded $66,314,790 pertaining to the settled claims, it will receive a credit for this amount.
“Federal health care programs provide critical health care services to millions of Americans,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We will hold accountable those who abuse these programs by knowingly billing for goods or services they did not provide.”
“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.”
“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."
“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.
“Medicare enrollees and consumers at-large rely on pharmacies for critical medications that sustain their quality of life," said Deputy Inspector General Christian J. Schrank of HHS-OIG.
The federal share of the recovery is $91,881,530; a total of $14,933,259 will be returned to individual states through separate settlement agreements with Medicaid participating states.
The settlement resolves three cases pending in New Mexico's District Court under qui tam provisions: Steven Turck filed suit related to billing Medicare/Medicaid in Texas' Eastern District Court receiving $14M+, while Andrew Bustos filed suit related to Medicare Part B billing receiving $1M+.
Trial Attorney Seth Greene; Assistant U.S Attorneys Ruth Keegan & Sean Cunniff; Auditor Julie Chappell; Assistant U.S Attorneys James Gillingham & Adrian Garcia; Senior Litigation Counsel Lindsay Griffin handled these matters with assistance from HHS-OIG & National Association Of Medicaid Fraud Control Units.
Tips about potential fraud can be reported at 800-HHS-TIPS (800-447-8477).