Walgreens Agrees to $60 Million Settlement in New York Medicaid Fraud Case

In a joint effort with several states and the federal government, the Attorney General reports, the State of New York secured a $60 million settlement to resolve allegations regarding that  Walgreens unlawfully overbilled Medicaid for certain drugs.

Walgreens Agrees to $60 Million Settlement in New York Medicaid Fraud Case

The alleged fraud involves Walgreens’ Prescription Savings Club (“PSC”) program. According to prosecutors, the retailer inflated the value of some prescription drugs provided via Medicaid, while it charged much less to clients purchasing the drugs out of pocket.

Walgreens did not reveal to the healthcare program the sale prices offered to clients, and the alleged scheme resulted in huge profits for the company, in the shape of inappropriate Medicaid reimbursements. The recent settlement concludes a whistleblower lawsuit filed in 2012 under the federal False Claims Act.

However, this is not the first New York Medical fraud lawsuit involving Walgreens. In fact, another settlement with the State of New York was reached in January 2019. At the time, Walgreens agreed to pay New York $6.5 million to resolve claims regarding how the company willfully and unlawfully oversold insulin pens to Medicaid patients.

Details of the case show how Walgreens had a sophisticated electronic system in place by which it was not possible for pharmacies to sell less than a full box of insulin pens, containing five pens, even when Medicaid beneficiaries needed a smaller dose. Moreover, Walgreens allegedly lied about how their supply of insulin did not go over the established threshold when in fact it did.

Both cases stem from whistleblower lawsuits and span a 10 year period in which Walgreens appears to have been fraudulently selling drugs and inflating prices.

Although Walgreens has recently entered into a Corporate Integrity Agreement with the Health and Human Services' Office of the Inspector General in order to comply with transparency standards, its reckless and unethical behavior comes at great cost. National health programs, such as Medicaid, depend on the ethical and integral behavior of drug suppliers and pharmacies, and their solvency is put at risk every time fraud occurs.

If you see something wrong, say something. Medicaid fraud hurts taxpayers, hurts our economy, harms patients and is just plain wrong.

If you know of a healthcare provider or company that is cheating its patients, call us. We can assist you in putting an end to the fraud and help you receive a large cash reward for your trouble. Connect with us 888.742.7248 or ONLINE.


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