Pharmacy to Pay $2.5M for Bad Medicaid Billings

Pharmacy was charged with overbilling hemophilia patients.

A whistleblower’s lawsuit has culminated in a pharmacy’s $2.5 million settlement for its improper Medicaid billings.

The lawsuit alleged that Trinity Homecare, which is owned by Walgreens and based in College Point, New York, encouraged infusion drugs for its hemophilia patients and presented claims to Medicaid for unnecessary or excessive quantities. In some instances, patients refused to accept the drugs, and in other cases, the pharmacy received excess shipments, which were all billed for drug deliveries.

“The hemophilia drugs dispensed and sent to patients in this case, per delivery, can cost as much as a new car,” New York Attorney General Eric Schneiderman stated in announcing the settlement. “Overbilling that drains dollars from our important Medicaid program harms the most vulnerable New Yorkers. We cannot allow it.”

In at least 1 instance, the pharmacy dropped off medication at a home without a patient’s signature, even though the drugs can be worth thousands of dollars per delivery, The Times Ledger reported. The transgressions occurred between 2007 and September 2011, and the amount billed totaled $2.5 million for 9 patients.

The state’s Medicaid program will be federally reimbursed and also receive $1.48 million for the infusion drug incidents. The whistleblower who tipped off the pharmacy’s wrongdoing was a former employee.