The United States Department of Justice (DOJ) recently announced a settlement with Milwaukee-based chain Hayat Pharmacy for $2.05 over allegations the pharmacy made false claims to Medicaid and Medicare for prescription medications.
The money from the settlement will be divided between the Wisconsin state government and the federal government. Wisconsin will receive approximately 34 percent of the payment, with most of the rest going to the federal government and about $242,000 going to a whistleblowing former pharmacist who filed the initial complaint under the qui tam provisions of the False Claims Act.
In the lawsuit, the government claimed Hayat Pharmacy submitted false claims to both Medicare and Medicaid in 2019 for a topical cream and a multivitamin. Hayat allegedly switched Medicare and Medicaid patients form lower-cost medications to these more expensive products without valid prescriptions or a documented, legitimate medical need.
During the period in which the fraud occurred, Medicaid paid thousands of dollars per prescription for the cream and hundreds more for each multivitamin prescription.
In addition to the money it will pay to settle the claims, Hayat also agreed to host yearly training sessions for staff at its pharmacies that covers topics such as fraud and abuse, waste, and compliance with rules regarding medication switches.
Hayat admitted no fault in the settlement agreement and blamed the accusations on a disgruntled former employee. The complaint filed against Hayat claimed the former pharmacist was fired after executives at Hayat discovered hew as looking for a new job.
Healthcare fraud results in billions of dollars in waste and losses every year in the United States. In many cases, only information provided by whistleblowers can blow these cases open, especially with regard to False Claims Act cases. This is why the FCA legislation includes the qui tam provisions that allow whistleblowers to file claims on behalf of the government and share in potential recovery.
For more information about filing a False Claims Act case and about how you can shine a light on fraudulent activity, contact an experienced whistleblower lawyer at Kardell Law Group.