|
FOR IMMEDIATE RELEASE
May 1, 2008
Illinois-Based Walgreen Co. will pay more than $380,000 to Resolve False Billing Practices Pursued by
Indiana Attorney General Steve Carter
INDIANAPOLIS, IN – Indiana Attorney General Steve Carter has recovered $337,050 for the state’s Medicaid program and another $44,800 in investigative costs from Walgreen Co. for alleged false billing under Medicaid’s Restricted Card Program. The payment resolves a 2004 lawsuit.
“We have implemented a corporate integrity agreement with Walgreens along with penalties to halt this practice going forward,” Carter said. “We will conduct another audit to ensure the practice has been stopped.”
In 2004, Carter filed a lawsuit in Marion Superior Court alleging the Walgreens pharmacy in Muncie, Indiana (2720 W. Jackson St.) submitted at least 490 false claims for prescriptions to at least 25 Medicaid recipients who were participants of its Restricted Card Program. Recipients whose drug usage indicates a possibility of abuse are given limited access to prescriptions. The program permits only certain doctors the ability to prescribe medications to these individuals. Pharmacies will not receive approval for reimbursement if the designated physician has not ordered the prescription.
In this case, the Attorney General’s Medicaid Fraud Control Unit (MFCU) found that the names of doctors were altered 490 times and received Medicaid reimbursement of more than $43,000 during a four year period from January, 2001 thru March, 2005. An ongoing investigation uncovered another 4,946 false claims from another 124 Indiana stores.
The $337,050.42 represents a refund to Medicaid of 3 times actual loses at the Muncie store plus 2 times actual loses at other Walgreens stores. Walgreens has approximately 130 stores statewide.
“There were controls in place that seemed to be systemically overridden to achieve an end result,” Carter added. “Manipulating the system harms the very people it is meant to protect from prescription abuse.”
Walgreens admits that it did not have adequate documentation on file to demonstrate compliance with the Restricted Card Program, but that it was a mistake or inadvertence, not due to any intentional act or wrong-doing on the part of Walgreens or its employees.
As part of the agreement, Walgreens will implement a corporate integrity agreement and provide training for its employees for a three-year period. It will also undergo another audit of its pharmacies to ensure no ongoing violations of the Restricted Card Program are occurring.
In 2007, the Attorney General’s Medicaid Fraud Control Unit recovered a record $14 million for the Medicaid Program. MFCU investigations have lead to 17 criminal prosecutions for billing fraud or patient abuse and neglect. Eleven (11) of those cases have resulted in criminal convictions with four cases pending. Additionally, another seven (7) individuals were convicted in 2007 as a result of charges filed in 2006.
-30-
|
