Wisconsin Community Services will reimburse federal and state funding sources after voluntarily disclosing overbilling practices by one of its pharmacists.
The Milwaukee-based nonprofit social service agency will pay $537,904.33 to resolve false claims for prescription medications submitted to Medicare and Medicaid, according to the U.S. Attorney’s Office for the Eastern District of Wisconsin.
The agency notified the office that one of its pharmacists submitted claims to Medicare and Medicaid that misrepresented prescription drugs dispensed by WCS over several years, according to a news release from U.S. Attorney Matthew D. Krueger.
Specifically, dispensed generic medications were billed as more expensive brand-name medications, resulting in significantly higher reimbursements to WCS, according to the release.
The agency provides a range of services, including outpatient mental health services and an associated pharmacy, according to the release.
Wisconsin Community Services operates on a nearly $26 million budget, about 80% of which is publicly funded, according to the most recent figures posted to its website.
The pharmacy is operated internally and the pharmacist responsible for the false claims has been fired, WCS Executive Director Clarence Johnson said Tuesday.
The Wisconsin Department of Safety and Professional Services has also been made aware of the matter, Johnson said.
“The State of Wisconsin is satisfied with how WCS has handled the matter and they are taking no further action,” Johnson said in an email.
“We are committed to providing the very best services for our participants and clients and they will not be adversely impacted by this outcome,” Johnson said.
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