Three items from the end of August. The one that matters most is a $50 million settlement that shows where controlled substance enforcement is pointed, and it points at the pharmacy that filled the prescription and not only at the prescriber who wrote it.
Walmart pays $50 million over unlawful controlled substance prescriptions
The Department of Justice announced that Walmart agreed to pay $50 million to resolve allegations that its pharmacies filled thousands of invalid prescriptions for opioids and other controlled substances. The principle underneath the case is corresponding responsibility, which places a duty on the pharmacist who fills a prescription and not only on the prescriber who wrote it. That duty is the exposure retail and independent pharmacies most often underestimate, because it does not require proof that anyone at the pharmacy knew a prescription was fraudulent. It asks instead what the pharmacy should have caught. The settlement terms are worth reading for the compliance obligations attached to them, since obligations negotiated in a case this size tend to become the practical benchmark that regulators and DEA measure smaller pharmacies against later. Read more at the Department of Justice →
A fifth hospital sues CVS over 340B reimbursement practices
A fifth hospital has sued CVS over its handling of 340B savings. At five suits this stops being an outlier and starts being a pattern. The claims go to whether savings meant for covered entities were captured elsewhere in the chain, which is a question that reaches well past the parties in any one case. Covered entities, and pharmacies operating under contract pharmacy arrangements, have reason to follow how these develop, because the outcomes will shape what a defensible 340B arrangement is understood to look like. Read more at Frier Levitt →
California is using AI to support Medi-Cal reenrollment
Hooper Lundy has a short piece on California turning to artificial intelligence to support Medi-Cal reenrollment. Nothing here asks a pharmacy to do anything today. It is worth knowing anyway, because reenrollment mechanics decide who stays covered, and coverage churn arrives at the pharmacy counter as rejected claims and as patients facing costs they did not expect. The direction the state is moving on this is worth watching. Read more at Hooper Lundy & Bookman →
This update is general information about developments in pharmacy law and regulation. It is not legal advice, it does not create an attorney-client relationship, and it should not be relied on as a substitute for advice about your own situation. Prior results do not guarantee a similar outcome. If you have a specific question about your pharmacy, call or write and we will talk about it properly.
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