Court Dismisses Texas Pharmacist’s False Claims Suit Against Walgreens

The Court of Appeals has ruled that a Texas pharmacist whistleblower has failed to adequately allege that Walgreens violated the False Claims Act by submitting false claims for reimbursement to Medicare and Medicaid.

The pharmacist, who had worked for Walgreens for close to 20 years, claimed that Walgreens’ pharmacists had submitted claims to Medicare and Texas Medicaid for things that were incorrectly prescribed, or for wrong doses or wrong medications. The pharmacist’s core allegations were 10 instances where Walgreens filled prescriptions and billed the state or Federal program, which the pharmacist alleged was a violation of the False Claims Act. However, the court disagreed with the pharmacist’s portrayal of the pharmacy’s actions and attributed them to mere mistakes or errors that did not rise to the level of Medicare fraud. The court stated that none of the pharmacist’s allegations amounted to “anything more than innocent mistake or negligence.”

The requirements for a False Claim Act claim are not met by “mere negligence or even gross negligence,” wrote the court in its decision. The court declined to give the pharmacist another chance to amend her complaint, noting that she had already been given a previous chance to amend it to address the deficiencies, and that her amended complaint suffered from the same deficiencies as the original one.