Pharmacist Whistleblowers Make Millions In Walgreens Medicaid Overbilling Settlement

By on January 23, 2019

Walgreens Boots Alliance Inc. will pay the U.S. Government $269 million to end False Claims Act allegations of overbilling for drugs.

The deals resolve two cases  filed by former Walgreens pharmacists under the False Claims Act (FCA) a federal law that rewards whistleblowers for exposing fraud against the federal government, by giving them a percentage of the money recovered by the government.

One of the complaints alleges excessive and unnecessary dispensing of insulin pens, and the other (unrelated) complaint alleges overcharging of Medicaid through false price reporting.

In the insulin case, the whistleblower will receive approximately 19% of the $41 million recovered in that case, or $7.6million.  The whistleblower in the false prices case will receive $11.4 million.

Typically, FCA cases, also called qui tam cases, are brought in the Medicaid/Medicare or defense contractor context, though any fraud on the government in any context is covered. The cases are initially filed “under seal”, meaning they are secret and not publicly available, while the government considers whether to “intervene”, or join, in the case, essentially taking it over from the whistleblower plaintiff.  Cases in which the government intervenes have a very high likelihood of settling. If the government does not join the case, the whistleblower has the option of pursuing the case themselves and collecting a percentage of any money recovered.

FCA claims are a way for whistleblowers to do the right thing– expose wrongdoing ultimately victimizing taxpayers — and to get paid for it.