On September 13, the U.S. Department of Justice (DOJ) announced that Walgreens Boots Alliance Inc. and Walgreen Co. agreed to pay $106.8 million to settle charges that it violated the False Claims Act (FCA) by billing government health care programs for prescriptions never dispensed.
According to the DOJ, “between 2009 and 2020, Walgreens submitted false claims for payment to Medicare, Medicaid and other federal health care programs for prescriptions that it processed but that were 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.”
“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.”
The settlement resolves allegations made in three separate qui tam whistleblower lawsuits. The False Claims Act’s qui tam provisions enable private citizens and private parties to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery.
Steven Turck, a former Walgreens pharmacy manager, alleged false billing of Medicare, Medicaid and other federal health care programs, and will receive $14,918,675 while Andrew Bustos, a former Walgreens district pharmacy supervisor, filed a qui tam suit related to billing Medicare Part B and will receive $1,620,000.
“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. “It is essential to hold pharmacies accountable when they knowingly fail to abide by the rules and requirements of our national health care programs.”
Healthcare fraud remains the number one area in False Claims Act enforcement. In FY 2023, the DOJ recovered $2.68 billion in FCA settlements and judgments, of which over $1.8 billion related to matters that involved the healthcare industry.
In July 2023, a bipartisan group of senators introduced the False Claims Amendments Act of 2023, which address a few technical loopholes undermining the success of the FCA. The bill is widely supported by whistleblower advocates.
National Whistleblower Center (NWC) has issued an Action Alert calling on Congress to pass the bill.
Join NWC in Taking Action:
Demand that Congress strengthen the False Claims Act
Further Reading:
Bipartisan Legislation Unveiled to Strengthen False Claims Act