(Adds details from decision, background, case citation, byline)
By Jonathan Stempel
Aug 15 (Reuters) - A federal appeals court on Tuesday revived a lawsuit in which the U.S and Virginia accused Walgreens Boots Alliance of falsely representing that some patients were eligible for Medicaid coverage for expensive hepatitis C drugs.
In a 3-0 decision, the 4th U.S. Circuit Court of Appeals in Richmond, Virginia cleared the way for the pharmacy chain to face claims it violated the federal False Claims Act and Virginia state law.
The case arose from accusations that between January 2015 and June 2016, a clinical pharmacy manager at a Walgreens in Kingsport, Tennessee, falsified patient records, including lab results, to obtain prior authorization from Virginia Medicaid for reimbursement for the drugs Sovaldi, Harvoni and Daklinza.
Revenue from the Kingsport store grew by 321% during that time, court records showed.
Walgreens began an investigation into the alleged fraud but did not repay money it received for 12 Virginia Medicaid patients, even after the manager pleaded guilty to a similar scheme in Tennessee.
In December 2021, a trial judge dismissed the governments' lawsuit, saying Walgreens' misrepresentations were immaterial because Virginia's prior authorization requirements violated federal law.
In Tuesday's decision, however, Circuit Judge Albert Diaz said Walgreens' alleged misrepresentations were material under the False Claims Act because they "did, in fact, influence...
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