Federal Court Reopens Lawsuit Accusing Walgreens Of Medicaid Fraud Over Hepatitis C Drugs

The 4th U.S. Circuit Court of Appeals in Richmond, Virginia, reinstated a lawsuit where the U.S. and Virginia allege Walgreens Boots Alliance Inc WBA fraudulently claimed some patients qualified for costly hepatitis C medications. 

The unanimous decision paves the way for Walgreens to confront accusations of breaching the federal False Claims Act and Virginia state regulations, Reuters reported.

The lawsuit centers on a Walgreens clinical pharmacy manager in Kingsport, Tennessee, who reportedly altered patient records between January 2015 and June 2016. 

The aim was to secure Virginia Medicaid approval for drug reimbursements for Sovaldi, Harvoni, and Daklinza. Consequently, the Kingsport store's revenue surged by 321% during the period.

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Although Walgreens initiated a probe, they failed to refund payments for 12 Virginia Medicaid beneficiaries, even posting the manager's guilty plea to a comparable scheme in Tennessee.

While the case was dismissed in December 2021 because Walgreens' false claims were inconsequential due to Virginia's breach of federal law, Circuit Judge Albert Diaz reversed the decision. 

He clarified that Walgreens' purported false claims were pertinent under the False Claims Act as they directly impacted Virginia Medicaid's decisions. Diaz further commented that Walgreens' attempt to evade responsibility by criticizing Virginia's eligibility standards as unlawful would counteract the act's aim of holding wrongdoers responsible.

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