Kroger Specialty Pharmacy Agreed to Pay $23.5 Million for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims Supported by False Prior Authorizations
After it self-disclosed conduct to OIG, Kroger Specialty Pharmacy, Inc. (Kroger), headquartered in Florida, agreed to pay $23,556,274.50 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Kroger submitted claims for payment to Federal health care programs for which a now former employee in Kroger’s patient access coordinator group falsified prior authorizations. Kroger’s now former employee would provide false and materially misleading answers to clinical questions and/or sign the authorizations as through she was the prescriber with the intent of influencing coverage decisions.
Action Details
- Date:May 10, 2024
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Enforcement Types:
- Fraud Self-Disclosures