A settlement has been reached to resolve False Claims Act allegations against Nashville Pharmacy Services LLC.
The allegations arose from a lawsuit that claimed Nashville Pharmacy Services overbilled Medicare and TennCare for pharmacy services.
On January 5, 2016, the Department of Justice disclosed that the settlement resolves allegations that Nashville Pharmacy Services automatically refilled medications without a request from the beneficiary, their physician, or a person acting as the beneficiary’s agent, in violation of TennCare’s contractual requirements; routinely and improperly waived TennCare and Medicare co-payments without an individualized assessment of those beneficiaries’ inability to pay; improperly used pharmaceutical manufacturers’ co-payment cards to pay the co-payments of certain Medicare recipients for thirteen Medicare beneficiaries; billed Medicare and TennCare for certain medications that were dispensed after the dates of death of 15 beneficiaries with either Medicare or TennCare coverage; and billed Medicare or TennCare for medications that lacked a valid prescription from a licensed provider for 22 beneficiaries with either Medicare or TennCare coverage.
The whistleblowers' share of the settlement will be approximately $1.4 million.
