Hirt v. Walgreen Co.
Hirt, owner of Andy’s Pharmacies, alleged that Walgreen Company distributed kickbacks ($25 gift cards) to Medicare and Medicaid recipients when they transferred their prescriptions to Walgreens, in violation of the Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b). Hirt claimed that Walgreens violated the False Claims Act, 31 U.S.C. 3729, by sending these fraudulent insurance claims to the government. The Sixth Circuit affirmed dismissal of his qui tam suit. Individual plaintiffs cannot bring qui tam complaints based upon information already in the public domain and must state with “particularity the circumstances constituting fraud or mistake.” Hirt’s complaint described the unlawful distribution of gift cards in general but not the submission of any claims obtained with those gift cards. He did not identify customers, dates on which they filled prescriptions at Walgreens, dates on which Walgreens filed reimbursement claims with the government, or even say that these unnamed customers filled any prescriptions at Walgreens at all, let alone that Walgreens processed them and filed reimbursement claims with the government. He did not allege personal knowledge of Walgreen’s claim submission procedures or allege facts “from which it is highly likely that a claim was submitted to the government.” View "Hirt v. Walgreen Co." on Justia Law