In a significant move to combat the opioid crisis, K-VA-T Food Stores Inc., doing business as Food City, has agreed to a settlement with the U.S. government addressing allegations under the False Claims Act (FCA). The opioid fraud settlement will see Food City pay $8,488,378 to the United States and an additional $78,621 to the states of Virginia and Kentucky for claims made to their Medicaid programs. This development is part of ongoing efforts by federal agencies to hold pharmacies accountable for their role in the opioid epidemic.
Accountability in Combating Prescription Misuse
The opioid fraud settlement centers around allegations that, from January 1, 2011, to December 31, 2018, 24 Food City pharmacies dispensed opioids and other controlled substances that were either medically unnecessary or lacked a legitimate medical purpose. According to the Department of Justice (DOJ), the pharmacies knowingly submitted or caused false claims to be submitted to federal healthcare programs. This settlement underscores the government’s commitment to using the False Claims Act to address fraudulent medical practices contributing to the opioid crisis.
Principal Deputy Assistant Attorney General Brian M. Boynton emphasized the importance of pharmacies ensuring that opioid prescriptions are medically necessary. “Pharmacies that fill prescriptions for opioids and other controlled substances have an obligation to ensure that those prescriptions are medically necessary,” Boynton stated. “The department is committed to holding accountable pharmacies that have abdicated this responsibility and thereby contributed to the nation’s opioid crisis.” His remarks highlight the gravity of the opioid fraud settlement in addressing systemic issues within the pharmaceutical industry.
Key Highlights of the Food City Opioid Fraud Settlement:
Collaborative Effort Across Agencies
The settlement underscores the joint effort between federal, state, and local agencies to combat healthcare fraud and address the opioid crisis.
Accountability Through the False Claims Act
The case highlights the government’s reliance on the False Claims Act to hold pharmacies accountable for submitting fraudulent claims related to opioid prescriptions.
Whistleblower Role
The lawsuit originated from a qui tam case filed by K-VA-T Litigation Partnership, LLP, showcasing the critical role of whistleblowers in exposing fraudulent practices. The whistleblower will receive $1.5 million from the settlement.
Protecting Public Health Programs
Officials emphasize the importance of safeguarding Medicare and Medicaid from fraudulent opioid prescriptions to ensure only medically necessary drugs are dispensed.
Defense Department Involvement
The settlement reflects the Department of Defense’s commitment to protecting servicemembers and their families from harm caused by unnecessary opioid prescriptions.
Continued Commitment to Fighting the Opioid Epidemic
The settlement reinforces the ongoing dedication of law enforcement and health agencies to mitigate the opioid crisis and prevent future fraudulent practices.
Holding Pharmacies Accountable: The Broader Impact of the Food City Settlement
The opioid epidemic continues to devastate communities across the nation, making such settlements critical in curbing its spread. The Food City opioid fraud settlement is a reminder of the importance of regulatory oversight and the role of the False Claims Act in promoting accountability. This case also reflects the broader efforts by government agencies, including the Defense Health Agency’s Pharmacy Operations Division, to ensure that pharmacies adhere to stringent prescription guidelines.
Ultimately, the opioid fraud settlement serves as a deterrent for other pharmacies that may consider bypassing medical necessity protocols. It reinforces the message that the government is vigilant in addressing fraud that contributes to the opioid epidemic. As the fight against opioid misuse continues, such settlements provide a pathway to greater accountability and help safeguard the health and well-being of countless individuals affected by opioid addiction.
Conclusion
The Food City opioid fraud settlement serves as a significant milestone in the government’s ongoing efforts to combat the opioid epidemic and healthcare fraud. By leveraging the False Claims Act, the Department of Justice, in collaboration with federal and state agencies, demonstrated a strong commitment to holding pharmacies accountable for dispensing medically unnecessary opioids.
The settlement also reflects the importance of regulatory oversight in protecting public health programs like Medicare, Medicaid, and TRICARE, which serve vulnerable populations, including veterans and their families. Ultimately, the resolution underscores the government’s unwavering stance on addressing the opioid crisis and preventing future misuse by pharmacies. As the opioid epidemic continues to devastate communities, such legal actions serve as both a deterrent and a necessary step toward greater accountability and public safety.