PORTLAND, Maine — Maine’s top federal prosecutor says Walgreens has agreed to pay $350,000 to settle claims that it improperly billed Maine’s Medicaid program.
U.S. Attorney Thomas Delahanty II said Thursday that a civil complaint alleged that the national drug store chain unjustly profited between November 2007 and July 2010 by billing MaineCare for prescriptions and dispensing fees without getting written signatures from customers in Maine, in violation of MaineCare regulations.
Delahanty said the investigation was conducted by the Maine Department of Health and Human Services, the U.S. Attorney’s Office and the U.S. Department of Health and Human Services.
When are they going to investigate Nutting?
This is where the biggest dollar amounts can be found from the fraud that occurs in Maine Care !
Driving yet another company from staying and doing business in Maine.
Anthem no longer allows prescriptions at Walgreens.
Really?
http://www.anthem.com/pharmacynetwork/
This article is so vague, it’s difficult to determine if this is actually fraud. Walgreens has an electronic signature capture system which *all* patients picking up scripts are required to sign, in order to bypass HIPPA and OBRA-90 regulations mandating an offer for pharmacist counseling. This is required by federal and state law. I find it hard to believe Walgreens, a big-box store identical to every other Walgreens in the nation, has no record of these electronic signatures. Either way, I don’t see why signatures are required for MaineCare if Walgreens is filling legitimate prescriptions for patients with MaineCare and there are records of these fills. Furthermore, I find it hard to believe Walgreens “unjustly profited” from these scripts. Pharmacies usually lose money on Medicaid scripts because customers can waive their $3 copays and Medicare often doesn’t pay enough for medications to break even. Pharmacies profit off private insurance company reimbursement [Anthem, Cigna, etc], not state insurance [MaineCare].
You ask a lot of pertinent questions, MadFerret9. There simply isn’t enough detail in this story to ascertain exactly what Walgreens did wrong. Incidentally, Walgreens opened their first Maine store (North Windham) in 2007, so the timeline in the story would suggest that they were non-compliant from the outset until they halted their improper practices in 2010. Why did it take the regulators three years or more to inform Walgreens that they weren’t following the correct procedure?
Ain’t Nutting wrong with this article. Too bad it doesn’t go further…. like into the Maine House.
Oh Boo hoo there is fraud and abuse in the system quick someone blame the Gov!!!!