New York – America’s Biggest Drugstore Chain Accused Of Defrauding Medicaid.

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    New York – Michael Behn, a former federal prosecutor, said, “The pharmacies nationwide had a pill flipping scheme.”

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    Behn helped expose how Walgreens exploited a Medicaid loophole.

    To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs.

    But it doesn’t bother to set price-ceilings on rarely-used versions.

    Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.

    The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each.

    Walgreens figured it could pocket millions by switching patients from tablets to capsules.

    Behn explained to Attkisson, “These are the ranitidine capsules.”

    “This is what was being prescribed?” Attkisson asked, pointing to the tablets. “And this is what was being given?” pointing to the capsules.

    Behn replied, “Correct. At three times or more the cost to taxpayers,” Behn answered.

    The scheme was blown wide open by a whistleblower, a pharmacist who doesn’t want to appear on camera. He said Walgreens rigged its computers to automatically switch to the most expensive type of pill.

    “The only way in which a computer system could switch from a tablet and a capsule, is if someone went in and manipulated the computer system,” Behn said.

    Attkisson asked, “And the fact that this was done nationwide indicates this was a corporate policy?”

    Behn responded, “That’s what we alleged.”

    By gaming the system, Walgreens managed to change over almost all Medicaid customers from cheap generic Zantac tablets to pricy capsules.

    In Florida alone, it cost taxpayers an extra $1.2 million the first year.

    And the pill-switching went on for several years nationwide, including other prescriptions: generic Prozac (fluoxetine) for depression, and generic Eldepryl (selegiline) for Parkinson’s.

    Walgreens denies wrongdoing and declined to be interviewed.

    But they recently agreed to pay back the government more than $35 million.

    And they’re not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more.

    The whole pill-flipping episode proves just how imperfect some drugstore chains can be.


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    10 Comments
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    Anonymous
    Anonymous
    15 years ago

    better sell my WAG shares quick

    Anonymous
    Anonymous
    15 years ago

    What they don’t mention – and I’m not saying the pharmacies were right here – is that at the standard price limits, the drugstores are hardly making a profit.

    A guy who owned a pharmacy several years back, told me at the time that even for very expensive drugs (read – big investment) the profit for a bottle was only $3.00 if it was paid thru Medicaid.

    And don’t think a pharmacy can be in business and not accept Medicaid…

    Universal health care anyone? What happens when we all have to start filling up our gas tanks to get to a pharmacy? And don’t get me started on doctors.

    I wish I had the solution. I don’t think anybody does.

    trish
    trish
    15 years ago

    innocent untill proven guilty

    Anonymous
    Anonymous
    15 years ago

    If they settled out of court, how can they be proven innocent or guilty?

    Anonymous
    Anonymous
    15 years ago

    Setteling is an admission of guilt.

    Is anyone honest in business anymore?

    Anonymous
    Anonymous
    15 years ago

    If this was not caught at national chains but at local and regional pharmacies (eg a brooklyn pharmacy) these sizable settlements would be splashed all over New York Times and they would come with jail time.

    Anonymous
    Anonymous
    15 years ago

    Settlements specifically say there is no admission of guilt. It looks like all the Rubashkin bashers (guilty until proven innocent) are on vacation.

    Anonymous
    Anonymous
    15 years ago

    ye, and while on vacation i wonder which meat they are buying in yehupitzville….

    A bunch of hypocrites…

    Doc
    Doc
    15 years ago

    The doctor prescribes just as Ranitidine 150mg- no mention of tabs or caps.

    I think the pharmacy made a clever way of beating the system- legally. They should publicize the scams Medicaid uses to cheat pharmacies and providers!

    Anonymous
    Anonymous
    15 years ago

    I guess all negative snakes know when it’s a mitzvah to be dan lekaf zechus.. “olam hofuch ro’eesi”.