BOSTON — Walmart has agreed to pay Massachusetts $500,000 after allegedly failing to follow prescription pricing procedures that are in place to keep costs down and prevent overcharges in the workers’ compensation insurance system.
The procedures, required by state regulations, ensure that prescription costs will be reviewed against certain regulatory benchmarks. According to the assurance of discontinuance, filed in Suffolk Superior Court, Walmart allegedly failed to follow those regulations when applying prices for various injured worker prescriptions from 2016 to the present.
The discounter issued a statement saying, “Walmart believes the settlement is in the best interest of all parties. We deny the allegations, and this settlement does not include any admission of liability. We are proud of our pricing model and legacy of introducing innovative solutions that increase access to quality, affordable health care resources. Among those solutions are our industry-leading $4 generic prescription program that launched more than 15 years ago, our private brand insulin that saves consumers up to 75% over branded insulin, and our affordable diabetes-management products and devices.”
State attorney general Maura Healey said, “Having a workers’ compensation system that is transparent, functional, and affordable is essential for employers and workers across Massachusetts. My office will continue to ensure that companies are following our state’s rules and regulations that guarantee drug pricing in our workers’ compensation system is handled fairly.”
Under Massachusetts’ Workers’ Compensation system, when employees are hurt on the job, they are entitled to lost wages, compensation for injuries, and payments for certain injury-related expenses. The system sets limits for the cost of prescriptions for injured workers and requires companies to validate prices against certain regulatory benchmarks before processing their charges, such as the Federal Upper Limit for Medicare and the Massachusetts Maximum Allowable Cost.
The case is part of an ongoing review by the attorney general’s office into prescription pricing procedures in the workers’ compensation system. Healey has now reached settlements with Walmart, Express Scripts, Optum Rx, Walgreens, Stop & Shop, and United Pharmacy for workers’ compensation drug pricing violations totaling over $16 million.