Long-term care pharmacy agrees to settlement over prescriptions billed without valid orders
Oct 11, 2026 edition · GC-2026-0122 · Published 2026-10-11 · Version 4 · Settled
Remedi agreed to pay more than $5.3 million over time to resolve allegations of Medicare and Medicaid billing without valid prescriptions. The ability-to-pay settlement arose from former employees’ whistleblower claims. It is an agreement to pay, rather than confirmation of completed collection.
What happened
DOJ’s September 17 announcement says Remedi SeniorCare Holding Corporation agreed to pay more than $5.3 million to resolve False Claims Act allegations involving prescription drugs dispensed to assisted-living residents in several states. The government alleged that Remedi billed Medicare and Medicaid from January 1, 2015, through March 31, 2021, despite lacking valid prescriptions. The settlement is based on the company’s ability to pay and is to be paid over time. Those terms do not establish that the full amount had already been received.
The resolution includes claims brought by former employees Maureen Gearhart and Laura Griffieth under the False Claims Act’s whistleblower provisions. DOJ says they will receive a share of settlement payments made over time. The matter involved DOJ’s Civil Division and the Southern District of Ohio, with assistance from HHS-OIG and the Ohio Attorney General. The resolved claims remain allegations, with no determination of liability. The operational concern is the connection between dispensing authorization and reimbursement: pharmacy and facility controls need to identify when the supporting prescription is absent or invalid before a federal-program claim proceeds.
Scope and timing
- Authority status
- Settled
- Applicability
- Operationally relevant
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal, Maryland
Why it matters
Long-term care pharmacy and facility workflows depend on valid, timely prescriber orders and controls that stop claims when an order is missing or expired.
Recommended action
Audit prescription-validity controls, emergency and refill workflows, prescriber-order retention, and claim edits for long-term care pharmacy services.
Case details
- agencies
- HHS Office of Inspector General
- entities
- Remedi SeniorCare Holding Corporation
- action Type
- Settlement
- event Date
- 2026-09-17
- alleged Conduct
- Billing federal healthcare programs for drugs allegedly dispensed without valid prescriptions.
- resolution
- Remedi agreed to pay more than $5.3 million over time based on ability to pay. The settlement resolves allegations without a determination of liability; completed collection is not established.
Operational lessons
- Validate prescription authority before dispensing and billing.
- Retain accessible prescriber-order evidence.
- Use claim edits to stop billing when required order data is missing.
Sources
- Maryland Long-Term Care Pharmacy Pays $5.3M to Settle Allegations of Billing for Drugs Without Valid PrescriptionsOfficial · HHS Office of Inspector General · Source review 2026-10-11
- DOJ Remedi settlement announcement, September 17, 2026Official · U.S. Department of Justice · 2026-09-17 · Source review 2026-10-14
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