US v. Walgreen Co., No. 22-1491 (4th Cir. 2023)
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The United States and the Commonwealth of Virginia (together, the “governments”) appealed the district court’s dismissal of their complaint under the False Claims Act and Virginia state law. The governments alleged that Walgreen Co. (“Walgreens”) misrepresented that certain patients met Virginia’s Medicaid-eligibility requirements for expensive Hepatitis C drugs. The district court dismissed the complaint, holding that Virginia’s eligibility requirements violated the Medicaid Act, and therefore Walgreens’s misrepresentations were immaterial as a matter of law.
The Fourth Circuit vacated and remanded. The court held that the governments plausibly allege facts that establish materiality. The court wrote that the alleged misrepresentation (that Patient 12 couldn’t use the cheaper drug alternative) has nothing to do with the eligibility requirements Walgreens now challenges. The district court didn’t explain how the supposed illegality of Virginia’s eligibility requirements rendered this misrepresentation immaterial or how it otherwise failed to state a claim. Further, the court explained it is also persuaded that Walgreens can’t avoid liability by collaterally challenging the eligibility requirements’ legality under a line of cases beginning with United States v. Kapp. Moreover, the court explained that Walgreens offers no good reason why a contract law (and even more specifically, a collective-bargaining-contract-law) rule should displace the liability created by the False Claims Act, a federal statute.
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