Walgreens-owned pharmacy settles second fraudulent billing case

July 24, 2015

New York State Attorney General Eric Schneiderman recently announced that a Walgreens-owned pharmacy must repay $22.4 million to the state’s Medicaid program for filing false billings.

New York State Attorney General Eric Schneiderman recently announced that a Walgreens-owned pharmacy must repay $22.4 million to the state’s Medicaid program for filing false billings.

This recent settlement is the second announced in as many months involving Trinity Homecare of College Point, New York. The company provides contract healthcare services for managed care insurance companies.

Michael Polzin, a Walgreen spokesman, said the company settled to avoid the delay, expense and uncertainty of litigation, and did not admit liability.

See also: Pharmacy to pay $8 million to settle fraudulent billing allegations

The case against Trinity Homecare, partially owned by Walgreens, was spurred by a whistleblower and was related to the drug Synagis, which is used to treat premature infants and can cost as much as $2,000 per dose.

According to Schneiderman, Trinity Homecare failed to provide basic documentation for the Medicaid claims it submitted and could not prove that the drug was delivered to patients.

 “The claims under investigation in this case were for a drug that is supposed to help some premature babies,” Schneiderman said. “It turned out that the pharmacy did not always have a prescription for that drug but billed Medicaid for it anyway. Of greater concern than the improper billing, is the possibility that infants could have received injections which were not properly prescribed to them.”

 

The state investigation began after a hospital physician told investigators that Trinity improperly obtained babies’ names and other patient information from the hospital’s neo-natal intensive care unit logbooks.

The physician’s name and medical license number (as well as those of other physician’s) was improperly used for a prescription for an infant never seen by the physician. The physician will be paid $4 million of the settlement.

Investigators also alleged that Trinity staff contacted doctors or children's families directly to try to sell the Synagis, dispensed refills that weren't necessary, and sometimes overstated the weight of babies so it could charge Medicaid for extra vials.

In June, Trinity agreed to pay $2.5 million to the Medicaid program after being unable to provide documentation that it delivered certain drugs for hemophilia patients for which it billed the program.