Express Scripts Must Face Drug Refill Fraud Suit in Reversal

A False Claims Act suit alleging Express Scripts Inc. dispensed more pills than the US Department of Defense’s Tricare program beneficiaries needed warrants another look, the Ninth Circuit said in a reversal.

The two public sources on which the district court based its dismissal don’t trigger the FCA’s public disclosure bar because they don’t provide enough detail to support a claim that ESI—now known as Evernorth Health Inc.—engaged in a practice of fraudulently overfilling prescriptions, the US Court of Appeals for the Ninth Circuit said in a Tuesday opinion.

The relator, referred to as 3729 LLC, filed the suit ...