A group of Blue Cross & Blue Shield plans sued Walgreens Boots Alliance, alleging they are being overcharged and have been for over 10 years.
The lawsuit, filed last week in federal court in Chicago, accuses the Deerfield-based pharmacy company of overcharging insurance companies by submitting prescription drug claims at artificially inflated prices.
The lawsuit alleges that for more than a decade Walgreens submitted claims based on false statements of its usual and customary prices—the price the general public would pay Walgreens for a prescription without going through insurance. The lawsuit alleges that "Walgreens has overcharged plaintiffs hundreds of millions of dollars for prescription drugs."
In an email, a Walgreens spokesman declined to comment.
The suit is based on Walgreens' having settled claims by the U.S. government and numerous states in January 2019 that alleged that from January 2008 through December 2017 the company violated the False Claims Act by overbilling Medicaid by not disclosing lower drug prices offered in its discount program, called the prescription savings club.
In January 2019 Walgreens settled two lawsuits brought by the federal government and several states that alleged Walgreens had defrauded Medicaid. Walgreens said it would pay $60 million to settle a lawsuit alleging it overcharged Medicaid by overstating its non-insurance cost for prescription drugs. In the other case, Walgreens agreed to pay $209.2 million to settle claims it had charged for insulin pens that it did not provide to Medicaid patients.
Walgreens admitted no wrongdoing in either case.
This lawsuit by Blues plans does not make mention of the insulin pen claims.
The complaint alleges that since 2007, when Walgreens first implemented its discount program, the chain has submitted to the plaintiffs, through their pharmacy benefit managers, more than 245 million brand and generic retail pharmacy claims for payment and that the plans reimbursed Walgreens more than $17 billion.
The plaintiffs are all Blue Cross & Blue Shield Association licensees. They are plans from Alabama, Florida, Kansas, Massachusetts, Minnesota, Nebraska, North Carolina, North Dakota and Wellmark Blue Cross & Blue Shield of Iowa, Wellmark BCBS of South Dakota and Wellmark Synergy Health and Wellmark Value Health.
None of the plans are part of Health Care Service Corp., the parent of Blue Cross & Blue Shield of Illinois.
"Group of Blues plans alleges Walgreens overcharged them" originally appeared in Crain's Chicago Business.