The Supreme Court heard oral arguments this week on whether major pharmacies illegally overbilled Medicare and Medicaid for prescription drugs, a case that could weaken a key law the federal government uses to stamp out fraud.
The case before the high courtopens in a new tab or window hinges on two whistleblower cases brought under the False Claims Actopens in a new tab or window, a 19th-century law described by one legal expert as the "weapon of choice" for going after healthcare fraud.
In the two cases against SuperValuopens in a new tab or window and Safewayopens in a new tab or window, whistleblowers accused the pharmacies of offering discounted prices to cash-paying customers while billing Medicare and Medicaid at higher rates, in effect overstating their "usual and customary" prices -- the cash price, without insurance, paid by the general public.
The False Claims Act calls for any person who knowingly submits a claim that is fraudulent or false, or knowingly makes a false statement about such a claim, to be liable for triple the damages plus a penalty tied to inflation, according to the Department of Justice (DOJ).opens in a new tab or window
Background
Back in 2006, Walmart shook up the retail pharmacy market by selling a number of commonly used drugs at a significant discount, some as low as $4 for a 30-day supply.
In an attempt to compete, other pharmacies, including SuperValu and Safeway, instituted price-match programs, in which, upon request, they would drop...
Shots fired inside the hotel hosting the White House Correspondents’ Association dinner attended by President Donald Trump caused immediate confusion about the suspect and what transpired at the A...