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    Former Walgreens manager to be sentenced in fraud case

    A former Walgreens clinical pharmacy manager faces up to 10 years in prison and a $250,000 fine when sentenced next year on fraud charges involving falsified claims for expensive hepatitis C medications.

    On Oct. 25, 2016, Amber Reilly, 33, of Jonesborough, Tenn., pled guilty to one count of healthcare fraud before U.S. District Judge J. Ronnie Greer in Greeneville, Tenn. Reilly, formerly the clinical pharmacy manager at the Walgreens Specialty Pharmacy in Kingsport, Tenn., is scheduled to be sentenced on Jan. 30, 2017.

    Editor’s Choice: PBMs, insurers strike deals for Hep C drugs

    According to prosecutors, between October 2014 and April 2016, Reilly falsified prior authorizations, medical lab reports, and drug test results for more than 50 patients with prescriptions for costly hepatitis C medications.

    Without the bogus paperwork, the patients’ insurance would not have covered expensive medications such as Solvaldi, Harvoni, Veikira Pak, or Daklinza.

    The patients in question were insured through TennCare, which does not pay for hepatitis C prescriptions for patients who either abuse illicit substances or who have limited or no scarring of the liver.

    Prosecutors alleged that the patients’ authentic lab reports and drug tests would have made them ineligible for insurance coverage for the expensive medications.

    Mark Lowery, Editor
    Mark Lowery an Editor for Drug Topics magazine.

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