Walgreens has agreed to pay $106 million to settle lawsuits that alleged the pharmacy chain submitted false payment claims with government health care programs for prescriptions that were never dispensed.
The settlement announced on Friday resolves lawsuits filed in New Mexico, Texas and Florida on behalf of three people who had worked in Walgreens’ pharmacy operation. The lawsuits were filed under a whistleblower provision of the False Claims Act that lets private parties file case on behalf of the United States government and share in the recovery of money, the U.S. Justice Department said. The pharmacy chain was accused of submitting false payment claims to Medicare, Medicaid and other federal health care programs between 2009 and 2020 for prescriptions that were processed but never picked up.
In a statement, Walgreens said that because of a software error, the chain inadvertently billed some government programs for a relatively small number of prescriptions that patients submitted but never picked up.
“Inadvertently” is carrying a lot of weight there.
I could pretty easily see how such a bug could happen if the description in the article is accurate.
The right way to do it is to have the entire transaction in some pending state, and nothing is permanently saved anywhere until the transaction is completed. (This is called an atomic operation. It usually applies to distributed databases, but the same concept applies here, where the transaction takes a long time to succeed or fail.)
If, instead, you add it to the “reimbursement list” while putting the actual “make the pill” and billing part in the pending state, then forget to remove it when the transaction isn’t completed, you get the outcome described in the article.
This would make sense on a smaller operation without a huge dedicated accounting team, fact that whistleblowers had to testify to fix it makes me doubt that’s the case.
They get a cash payout as a whistleblower. I could easily see not reporting it directly and reporting it through the channels that pay them instead. Also, if they contracted out, they may not have anyone with the basic understanding of tech to identify the issue even if “these requests shouldn’t have been filed” was reported up the chain.
It’s still negligence, but it doesn’t have to be deliberate fraud.
I mean, it’s possible that the software bug happened organically, but certainly at some point in the last decade management must have heard about it.
This is what I am saying. It stops being an accident and instead a cover-up the moment anyone in management knows about it.
submitting false payment claims to Medicare, Medicaid and other federal health care programs between 2009 and 2020 for prescriptions that were processed but never picked up
It took 40 years, but we finally found a welfare queen!
Walgreens and CVS should be broken up. Cvs is even worse somehow with their fake insurance company that forces you to get prescriptions only from cvs.
I’m of two minds here. Part says they could and should lose their license to dispense and government contracts; the other part knows this is often the only pharmacy people can access.
Sounds like the company needs to be forced to pay for full time government employees who supervise the company to insure compliance.
I’d prefer rich corporations and individuals be heavily taxed to pay for universal comprehensive care. No means testing, deductibles, or copay.
Absolutely agree, but at some point there will still be someone reporting expenses to the government and that needs to be trustworthy info.
its our pharmacy but the real bad part is then we are just stuck with cvs. its like taking out comcast.
They’ll be filing for bankruptcy within a decade tops, anyways.
And laughing all the way to their offshore banks, should that happen.
Everyone wants AI, so make a system that scans for doctors, drug prescription, and frequency of prescription. (Above). Hire people to review doctors and accuracy (see above).
Do random sampling with people investing if incorrect. Make doctors upload prescription direct to a system that has the information protected from third parties.
People just go onto a site to request next dose after a safe period of designated time. Click the code associated with original package mail to house by USPS.
Hire people for support and accuracy of delivery. Pay all involved a livable wage with good benefits.
Either manufacturer or work with companies to supply effect low cost options with refund directed in R&D ( lower corporate tax rate or cash ).
Strong economy follows.
Questions? Suggests? Comments?
