News  Colorado-based Pharmacy to Pay $1 Million for Operating an Unauthorized Automatic Refill Program

Boston — A Colorado-based pharmacy that previously operated in Massachusetts will pay $1 million to resolve allegations that it improperly billed the state’s Medicaid program (MassHealth) when it automatically refilled prescription medications that were not specifically requested by MassHealth patients, Attorney General Maura Healey announced today.

Under the terms of the settlement agreement, BioScrip Pharmacy will pay $1 million to resolve allegations that from March 2009 through May 2012, the company automatically refilled prescriptions and billed MassHealth inappropriately as a result.

“This company operated an unlawful program that took away funds from individuals and communities that need them,” said AG Healey. “Our settlement ensures that this pharmacy discontinues its use of unauthorized automatic refill programs in Massachusetts and requires it to pay a significant penalty for violating out state laws.”

Current regulations prohibit pharmacies in Massachusetts from automatically refilling prescriptions that were not explicitly requested by a MassHealth patient or caregiver at the time of each filling event. These regulations aim to ensure that pharmacies will not routinely bill MassHealth for excessive or medically unnecessary prescriptions. This matter was referred to the AG’s Office by MassHealth.

The AG’s Office has previously resolved cases with pharmacies for using improper automatic refill programs for MassHealth members. In December 2018, Target agreed to pay $3 million to MassHealth to settle federal and state allegations of administering an automatic refill program. In August 2018, PharmaHealth agreed to pay $360,000 to settle allegations of operating an unauthorized automatic refill program. In 2015, Neighborhood Diabetes paid $1.5 million to resolve similar allegations.

This matter was handled by Assistant Attorney General Anthony Vargas and Investigations Supervisor Christopher Cecchini, both of the AG’s Medicaid Fraud Division. MassHealth provided substantial assistance with this investigation.