NEW YORK — The New York State Attorney General’s Office has reached a settlement with the Walgreen Co. after an investigation determined that more than 3,000 people insured by the New York State Empire Plan were misled into thinking they were covered for flu shots administered at the pharmacy when they were not.
The settlement requires Walgreens to cease advertising free flu shots for Empire Plan members and refund payments to consumers who were forced to pay for flu shots out of their own pocket.
The state started an investigation into the chain’s flu-vaccination and billing practices after receiving complaints through its Health Care Bureau Helpline that the pharmacy incorrectly advertised and informed Empire Plan members that it participated with their health plan and could provide flu shots to them at no out-of-pocket cost when actually the shots for members are covered only when administered in a physician’s office.
The investigation found that 3,000 Empire Plan members were vaccinated at Walgreens retail pharmacies during the 2010 and 2011 flu seasons.
After their insurance claims were denied as a non-covered service, Walgreens billed the members for the $30 cost of the vaccine. Of the 3,000 billed, 1,647 consumers paid the full amount out of their pockets and will be reimbursed.
“Vaccinations are a key public-health strategy in preventing the spread of the flu in New York state and nationally,” Attorney General Eric T. Schneiderman said in a news release. “By refunding customers, this settlement will ensure that Walgreens will not contribute to any consumer confusion that could negatively impact public vaccination efforts.
“While our office supports the increased availability of vaccinations through retail pharmacies, stores like Walgreens must be prepared to let consumers know whether their flu shots are covered by an insurance plan when administered at their stores.”
As a result of the investigation, Walgreens has to stop the promotions, review its records for Aug. 15, 2010, to now for Empire Plan members who paid for flu shots and make sure they aren’t being billed, make sure staff accurately communicate coverage information, submit a report documenting the Empire Plan members to whom refunds were paid and pay the state $15,000 in additional costs.
Consumers with questions or concerns may call the Attorney General’s Health Care Bureau Helpline at 1-800-428-9071.