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A pharmacy’s Medi-Cal provider status was terminated for violations of pharmacy law by DHCS even though the Pharmacy Board declined to take action
On December 9, 2009, in the case of Golden Drugs Co. Inc. v. Maxwell-Jolly, Case No. C058178, the California Court of Appeal issued a decision which upheld the termination of a pharmacy’s Medi-Cal provisional provider status by the Department of Health Care Services (DHCS). The DHCS terminated provider status based on a violation of pharmacy law rather than billing fraud. The Board of Pharmacy declined to take action.
The case arises from a DHCS auditor’s observation of a pharmacy technician filling prescriptions without a pharmacist’s supervision. The Court of Appeal found that the termination was authorized by law based on the evidence presented against the pharmacy in writing to an administrative law judge of the DHCS Office of Administrative Hearings and Appeals (OAHA). The only evidence presented by the pharmacy was a letter from the Pharmacy Board stating that it had insufficient evidence of a pharmacy law violation.
The case is attached below.