- Office of Attorney General Maura Healey
Media Contact for North Chelmsford Pharmacy to Pay $500,000 to MassHealth over Claims of Operating an Automatic Refill Program
Boston — A pharmacy in North Chelmsford has agreed to pay $500,000 to resolve allegations that it improperly billed and received payments from the state’s Medicaid Program (MassHealth) by operating an automatic refill program, Attorney General Maura Healey announced today.
Under the terms of a settlement agreement, Remedium Pharmacy, LLC (Remedium) will pay $500,000 to resolve allegations that from February 2015 through August 2019, the company automatically refilled prescription medications that were not explicitly requested by MassHealth recipients.
“Operating these automatic refill programs wastes precious health care resources and is a violation of the law,” said AG Healey. “This settlement will return lost funds to MassHealth and will ensure taxpayer funds are spent appropriately moving forward.”
“MassHealth identified allegations of improper billing by Remedium Pharmacy, LLC and referred the company to the Attorney General's Medicaid Fraud Division” said Dan Tsai, Assistant Secretary for MassHealth. “Today’s outcome is the result of MassHealth’s strong program integrity efforts to prevent inappropriate payments, and demonstrates the important partnership between MassHealth and the Medicaid Fraud Division.”
State regulations prohibit pharmacies in Massachusetts from automatically refilling prescriptions for MassHealth members that were not explicitly requested by the patient or caregiver at the time of each filling event. This matter was referred to the AG’s Office by MassHealth.
In addition to making a payment to MassHealth, Remedium will hire an independent compliance monitor and institute a multi-year compliance and monitoring program to ensure compliance with all federal and state laws and regulations governing pharmacies’ participation in MassHealth.
The AG’s Office has previously resolved cases with pharmacies for using improper automatic refill programs for MassHealth members. In 2019, Bioscrip Pharmacy paid $1 million to MassHealth to resolve allegations of operating an automatic refill program. In December 2018, Target agreed to pay $3 million to MassHealth to settle federal and state allegations of administering an automatic refill program.
In the AG’s Office, this matter was handled by Assistant Attorney General Christina Chan, Investigations Supervisor Christopher Cecchini and Investigator Shelby Stephens, of AG Healey’s Medicaid Fraud Division. MassHealth assisted with this investigation. The Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the Commonwealth of Massachusetts.