ILNews

CVS to pay $400k to state over illegal billings to Medicaid

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Indiana Attorney General Greg Zoeller announced Wednesday that CVS has agreed to a settlement to resolve allegations that its pharmacists submitted illegal billings for prescriptions to Medicaid for reimbursement.

The AG’s Medicaid Fraud Control Unit investigated allegations that some CVS pharmacy stores circumvented the Restricted Card Program by filling prescriptions not written by RCP-designated doctors and submitting claims to Medicaid that falsely identified the prescribing physicians as being designated so in order for Medicaid to pay for the drugs, according to a statement from the AG’s office.

The AG’s office did not identify the store locations.

Through the Restricted Card Program, Medicaid patients whose drug usage indicates abuse are given limited access to prescriptions and only certain physicians are permitted to prescribe medications for them.  Under the RCP, pharmacies typically will not receive reimbursement from Medicaid if a designated physician has not ordered the prescription for an RCP patient.

CVS will pay $400,000 and inform its pharmacists and pharmacy technicians of their obligations required under the RCP as part of the settlement.

 

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  1. Don't we have bigger issues to concern ourselves with?

  2. Anyone who takes the time to study disciplinary and bar admission cases in Indiana ... much of which is, as a matter of course and by intent, off the record, would have a very difficult time drawing lines that did not take into account things which are not supposed to matter, such as affiliations, associations, associates and the like. Justice Hoosier style is a far departure than what issues in most other parts of North America. (More like Central America, in fact.) See, e.g., http://www.theindianalawyer.com/indiana-attorney-illegally-practicing-in-florida-suspended-for-18-months/PARAMS/article/42200 When while the Indiana court system end the cruel practice of killing prophets of due process and those advocating for blind justice?

  3. Wouldn't this call for an investigation of Government corruption? Chief Justice Loretta Rush, wrote that the case warranted the high court’s review because the method the Indiana Court of Appeals used to reach its decision was “a significant departure from the law.” Specifically, David wrote that the appellate panel ruled after reweighing of the evidence, which is NOT permissible at the appellate level. **But yet, they look the other way while an innocent child was taken by a loving mother who did nothing wrong"

  4. Different rules for different folks....

  5. I would strongly suggest anyone seeking mediation check the experience of the mediator. There are retired judges who decide to become mediators. Their training and experience is in making rulings which is not the point of mediation.

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