Milwaukee Employment Law Blog

A national pharmacy chain that operates locations throughout Wisconsin has settled a whistleblower lawsuit that alleged the company filled prescriptions without verifying their medical necessity. Medicaid rules require pharmacies to verify medical necessity for certain stimulant medications before seeking reimbursement from the Medicaid program. The rules serve a gatekeeping role to ensure that taxpayer money that is used to purchase prescription drugs only pay for medications that are medically necessary, according to Matthew D. Krueger, United States Attorney for the Eastern District of Wisconsin.

In the recent lawsuit, workers noted that the pharmacy chain allegedly was not verifying medical necessity for stimulant prescriptions, such as those that are designed to treat such as attention deficient disorder, before seeking funds from Medicaid to pay for the medications.

A former quality control manager for a Southern mortgage company says that the lender engaged in wrongful activities to increase chances that loans would be approved, according to a recent whistleblower lawsuit. The alleged scheme used several tactics, including burying information in the notes section of forms instead of the reporting section, approving unqualified borrowers and falsifying borrower documents. The goal was to boost profits for the lender in loans backed by the Federal Housing Administration.

The whistleblower first noticed abnormalities when an elderly borrower complained about be lied to by the loan officer in a reverse mortgage process, according to the lawsuit. After reviewing the files, the former quality control worker says that she found that the loan officer was not licensed in the state where the allegations arose. She claims that the paperwork was not in order and the loan officer took funds before the borrower signed documents confirming his Intent to Proceed.

When Wisconsin voters went to the polls in November of last year to choose a governor, they elected Tony Evers over incumbent Scott Walker. The change in direction was apparent on Evers' first day in office, when he signed an executive order that prohibits discrimination against LGBTQ state employees.

His order did not stop there. Evers also directed officials to put standard terms in vendor contracts requiring the state to hire only on the basis of merit. That means that companies getting taxpayer monies cannot discriminate based on sexual orientation or gender identity.

A company on the East Coast that provides audiology services has agreed to settle a whistleblower lawsuit involving claims of unlawful enticements and inappropriate examinations, according to the Department of Justice. Authorities say that the health care company allowed unlicensed individuals to conduct unsupervised audiology tests on patients who were covered by Medicare or Tricare.

The business admitted billing the government programs for reimbursement in violation of the False Claims Act, according to court documents. Additionally, federal officials say that the audiology services provider used unlawful enticements to attract government health care beneficiaries. Included in the promotions were offers of gift cards, turkeys, as well as a contest where beneficiaries of Medicare or Tricare could enter to win an iPad.