AMICUS:United Stated v. Walgreens Co., United States Court of Appeals for the Fourth Circuit

Executive Summary

The U.S. and Virginia filed suit against Walgreens for the submission of false claims seeking reimbursement for Hepatitis C medications provided to Medicaid beneficiaries who did not meet Virginia’s criteria for coverage. The district court dismissed the case, and the U.S. and Virginia appealed. The National Health Law Program filed an amicus brief urging the court to affirm the district court’s holding that Virginia’s coverage criteria for Hepatitis C medications violated the Medicaid Act. The brief emphasizes that direct-acting antivirals (DAAs) are lifesaving treatment for people with chronic Hepatitis C and explains that the Medicaid Act requires states to cover DAAs when prescribed for their medically accepted indications.