On 23rd January 2019, Matthew D. Krueger, United States Attorney, reported that Walgreen Co. has consented to reimburse 3.5 million U.S. dollars to the State of Wisconsin and the United States to resolve accusations that Walgreens Co. breached the False Claims Act by submitting submissions to the Medicaid program for intoxicant drugs without observing the Medicaid policies intended to make sure that intoxicants are distributed for proper medical treatment.
Walgreens Co. controls retail dispensaries all over Wisconsin State. The Wisconsin Medicaid program will pay a pharmacy for distributing certain intoxicant drugs only if the pharmacy initially proves with the prescribing doctor that the doctor wrote the intoxicant for medically proper treatment, like for attention deficit disorder treatment. The False Claims Statute bars a pharmacy from intentionally submitting claims for reimbursement for drugs in breach of Medicaid’s laws.
The State of Wisconsin and the United States purport that, between 2011 and 2014, Walgreens Co. breached Wisconsin Medicaid guidelines by regularly distributing intoxicant drugs to Wisconsin Medicaid payees first by not confirming that the prescribing doctor ordered the drug for medically suitable treatment. The State of Wisconsin and the United States also purport that, by not proving that drugs were prescribed for apt treatment, Walgreens Co. distributed and charged Wisconsin Medicaid for medically unnecessary drugs.
Matthew D. Krueger, United States Attorney, stated that Pharmacies perform a significant gate-keeping role in the Medicaid program to make sure that the millions of U.S. dollars used every year to purchase medications that are medically required. Krueger added that the resolution shows that the Justice Department will hold accountable their pharmacies for their criminal actions.
Lamont Pugh III, Special Agent-in-Charge for the HHS-OIG (Department of Health and Human Services- Office of Inspector General) – Chicago Region, stated that the distribution of any type of drugs require to be done while observing all rules and regulations and with proper authentication to make sure the medical requirement of the treatment. Pugh added that the resolution comprises an Office of Inspector General Corporate Integrity Deal that involves stipulations, like multi-site claims audit to be carried out by an Independent Review Organization, that pursue to support obedience to Federal health care program policies. Pugh assured that the Office of Inspector General would collaborate with their local, state, and federal law enforcement partners to safeguard the health and safety of Medicaid patients and important taxpayer funds.
Justin Tolomeo, Special Agent-in-Charge of the Federal Bureau of Investigations (FBI), stated that the Federal Bureau of Investigation prioritizes consumers’ protection and will persistently hold healthcare givers who abuse the Medicaid program accountable. Tolomeo further added that the 3.5 million U.S. dollars resolution indicates that violations of Medicaid laws substantially affect the health care industry and taxpayer dollars.
Michael Carter, United States Assistant Attorney, represented the United States government in this case. The OIG (Office of Inspector General), the Federal Bureau of Investigations, and the Wisconsin Department of Justice Medicaid Fraud Control and Elder Abuse Unit supported the investigation of this case. The settlement deal only carries accusations; Walgreens Co. doesn’t admit responsibility for any of the charges.
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