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  • Unlawful Pharmacy Audits: Wyoming Discount Pharmacy, LLC et al. v. Michigan Department of Health and Human Services

Sommers Schwartz attorneys Jason Thompson and Rod Johnston filed a class action lawsuit against the Michigan Department of Health and Human Services (MDHHS) on behalf of independent pharmacies across Michigan.

According to the complaint, the defendant violated the Michigan Constitution and the  Administrative Procedures Act (APA) by arbitrarily conducting prescription audits of independent pharmacies, purportedly to detect fraud, waste, and abuse related to Medicaid billings.

Specifically, the plaintiffs allege that MDHHS performed its audits without first promulgating rules, as required by the APA, for how those audits were to be structured and conducted. Without a process in place, MDHHS was misinformed that the plaintiffs were “overpaid” by Michigan Medicaid, prompting officials to demand repayment of the false and inflated amounts.

The plaintiffs further allege the defendant performed its audits without establishing a procedure for independent pharmacies to respond to the audit findings. The plaintiffs claim MDHHS violated their due process rights because they were not provided a meaningful opportunity to respond to the inaccurate audit results.

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