We'll get back to that in a bit, but first a report on some chain drugstores who have been more naughty than nice when it comes to their dealings with taxpayer dollars. First we go to the smog-choked depths of Fresno. Home of the worst air quality you've never heard of, probably because to report it would mean admitting to having visited Fresno. While passing out the stacks of albuterol to the people of the San Joaquin valley though, it seems like Walgreen's was up to a bit of no good:
A federal judge in Fresno has reinstated a jury award of more than $1 million in punitive damages against Walgreens for firing a pharmacist who blew the whistle on alleged billing fraud...In August 2011, a jury awarded Fresno pharmacist Sami Mitri $88,000 in general damages and $1,155,000 in punitive damages.
According to court documents, Mitri began working as a pharmacist for the company in 1996. He later was promoted to pharmacy manager in Walgreens’ Fresno district. The court documents say he first brought the billing fraud to the attention of Walgreens officials in the spring of 2009; Jones said Mitri learned of the illegal practice because he frequently filled in for Walgreens pharmacists throughout the Valley.
After he was fired in January 2010, Mitri sued for wrongful termination under the whistle-blower statute that protects workers who report employer misconduct.
In a nine-day trial in August 2011, evidence revealed that more than 20 Walgreens stores from Atwater to Tulare and Coalinga to Porterville were found to have fraudulently billed the government involving Medicare and Medi-Cal patients, Jones said.
For example, if a patient needed 30 pills, Walgreens would give them 10 and give them an IOU for the rest of the pills, Jones said. Walgreens would then bill the government for 30 pills, he said.
This illegal practice also involved expensive and time-sensitive medication done by injections, he said.
This one baffles me. I did some time back in the day working for the pharmacy America trusts when they're too lazy to get out of their car, and it was very...very...clear how partial fills were to be handled. The company had just been busted for this exact thing not long before and had re-tooled its software to handle these "partial fills," billing only for the amount given to the customer at the time, and for the balance owed only when it was actually dispensed.
Furthermore, they were adamant to the point of crazyness that any new hires complete their computer-based training on this partial fill procedure RIGHT NOW!!!, and the documentation that they had done so was put in their permanent personnel records. So for them to get busted for the exact same thing, while firing the guy who brought it to their attention, seems incredible. I suspect the problem was an ignorant District Manager or two. Ignorant District Managers are about as rare as that smog over Fresnoville.
Anyway, whenever I hear a story like this my reaction is always the same. "Goddammit why couldn't that have been me." Cashing in while striking a blow against the corporate bastards that have ruined our profession, what a true win-win that would be. I had a set of standing orders for my keystone tech to periodically rake her memory for things the corporation could have done in the past, as well as keep her eyes out for anything in the present we might be able to cash in on. And until today, I figured we just weren't lucky enough to be in a location where any shenanigans were happening. If you're thinking the same way, prepare to read this one and weep:
Rite Aid Corp. recently agreed to pay $2.99 million to settle federal charges it used gift cards to entice Medicare and Medicaid beneficiaries to transfer their prescriptions to its pharmacies.
According to the U.S. Department of Justice, from 2008 to 2010, Rite Aid “knowingly and improperly” influenced the decisions of Medicare and Medicaid beneficiaries to transfer their prescriptions by offering them gift cards.
Everyone who works in a chain pharmacy just gasped right now. I heard it. Every single one of you has gone through the gift card bullshit, and many of you noticed the fine print that says these cards were not to be given to Medicaid or Medicare beneficiaries. Those silly few who actually tried to enforce that restriction were universally....universally he said, meaning every time, by everyone, told to give them the cards anyway.
At least, I used to think those few attempted enforcers were silly wasters of time:
The case stemmed from allegations made by pharmacist Jack Chin. The Justice Department said that as a whistleblower, Chin is entitled to $508,300 of the funds recovered from Rite Aid.
GODDAMMIT!!!!!! GODMUTHERFUCKINGOFCHRISTDAMMITT!!!!! IT WAS IN FRONT OF MY FACE THE WHOLE TIME!!!!!! THE WHOLE GODDAMN TIME I WAS TOILING AWAY FOR THOSE ASSHOLES THE ABILITY TO KICK THEM IN THE NUTS WAS DANGLING RIGHT IN FRONT OF ME!!!!! EVERYONE KNEW ABOUT THE GIFT CARD SCAM!!!! EVERYONE!!!!!!!
Except......only one person was smart enough to do something about it. Sigh.
I'd like to blame my old keystone tech for the fact that 500 large isn't headed our way, I did issue those standing orders after all. but....no....the buck stops here. So instead of being able to hire a pharmacist to run my store so I can go into the mountains and hang out with the bears, I will be going in to my store tomorrow as usual.
Which still beats the shit out of working for them.
So the best I can do now my friends is to pass on a little advice. The gift card thing will come around again, and when it does, there will be irate customers who don't understand why they can't have one. When that happens, it might not be a bad idea to ask your District Manager for guidance as to what to do. Ask him in writing. And keep his reply for future reference.
Because evidently getting busted for something, and putting procedures in place to keep from getting busted again, isn't always enough to overcome the power of ignorance when it rests with a District Manager type.
I know a good pharmacy lawyer. When the time comes drop me a line and I'll put you in touch.