© Reuters. FILE PHOTO: Pigeons are seen resting on signage for Walgreens, owned by the Walgreens Boots Alliance, Inc., in Manhattan, New York Metropolis, U.S., November 26, 2021. REUTERS/Andrew Kelly/File Picture
By Jonathan Stempel
(Reuters) -A federal appeals court docket on Tuesday revived a lawsuit wherein the usand Virginia accused Walgreens Boots Alliance (NASDAQ:) of falsely representing that some sufferers had been eligible for Medicaid protection for costly hepatitis C medication.
In a 3-0 determination, the 4th U.S. Circuit Courtroom of Appeals in Richmond, Virginia cleared the way in which for the pharmacy chain to face claims it violated the federal False Claims Act and Virginia state legislation.
The case arose from accusations that between January 2015 and June 2016, a medical pharmacy supervisor at a Walgreens in Kingsport, Tennessee, falsified affected person information, together with lab outcomes, to acquire prior authorization from Virginia Medicaid for reimbursement for the medication Sovaldi, Harvoni and Daklinza.
Income from the Kingsport retailer grew by 321% throughout that point, court docket information confirmed.
Walgreens started an investigation into the alleged fraud however didn’t repay cash it acquired for 12 Virginia Medicaid sufferers, even after the supervisor pleaded responsible to the same scheme in Tennessee.
In December 2021, a trial choose dismissed the governments’ lawsuit, saying Walgreens’ misrepresentations had been immaterial as a result of Virginia’s prior authorization necessities violated federal legislation.
In Tuesday’s determination, nevertheless, Circuit Choose Albert Diaz mentioned Walgreens’ alleged misrepresentations had been materials beneath the False Claims Act as a result of they “did, the truth is, affect the decisionmakers” at Virginia Medicaid.
He additionally mentioned the most important U.S. pharmacy chain couldn’t escape legal responsibility by attacking Virginia’s eligibility necessities as unlawful.
“Permitting Walgreens to keep away from legal responsibility by difficult Virginia’s eligibility standards solely after getting caught would hinder the act’s goal of holding fraudsters accountable,” Diaz wrote.
Walgreens didn’t instantly reply to requests for remark. The U.S. Division of Justice and Virginia’s legal professional basic had no speedy remark.
The case is U.S. et al v Walgreen Co , 4th U.S. Circuit Courtroom of Appeals, No. 22-1491.