Walgreens to pay $7M for accepting alleged FCA violation proceeds
By 
Aaron Nicodemus2023-01-30T17:13:00
Retail pharmacy chain Walgreens agreed to pay $7 million to settle alleged violations of the False Claims Act (FCA) that it overbilled the state of Tennessee’s Medicaid insurance program for Hepatitis C medications and kept the proceeds even after it discovered an employee’s misconduct.
Before 2019, TennCare, the state’s Medicaid program, required prior authorization based on eligibility criteria for coverage of certain Hepatitis C direct-acting antiviral medications.
From 2014-16, a former pharmacist and store manager of a Walgreens in Kingsport, Tenn., falsified prior authorization requests for 65 TennCare patients so they could receive coverage for their Hepatitis C medications, the Department of Justice (DOJ) said Friday in a press release. The pharmacy chain retained the proceeds from the improper claims even after the scheme came to light, the DOJ said.
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