Kmart pays $525k to settle Medicaid fraud claims

Kmart Corp. reached a $525,000 settlement to resolve allegations it knowingly submitted claims to California’s Medicaid program that defied diagnosis and documentation requirements.

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The accusations were first raised in a whistle-blower lawsuit filed against Kmart under the qui tam provision of the False Claims Act. The lawsuit, filed by a pharmacist who served as pharmacist in charge at a California Kmart store, alleged Kmart failed to confirm and document approved diagnoses for drug reimbursement under Medi-Cal’s formulary list. The lawsuit also argued Kmart dispensed prescriptions for nonapproved diagnoses and knowingly billed Medi-Cal for the reimbursement.

The settlement doesn’t determine liability, but resolves the allegations.

The pharmacist who filed the whistle-blower suit will receive about $96,500 of the settlement.

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