At issue was whether companies can avoid liability for fraud by showing that an "objectively reasonable" reading of the law supported their conduct - regardless of whether they truly believed that interpretation at the time of their alleged wrongdoing.
The whistleblowers, seeking monetary damages, accused the companies of offering prescription drugs at discounted prices to most customers paying out of pocket, while improperly charging higher rates to the government. Government healthcare programs reimburse pharmacies for dispensing covered drugs to beneficiaries.
Whistleblower Thomas Proctor sued Safeway while whistleblowers Tracy Schutte and Michael Yarberry sued SuperValu. The whistleblowers said federal law requires pharmacies to bill the Medicare and Medicaid programs the same prices it charged the general public under a rate known as a pharmacy's "usual and customary" price. They also said both companies knew they were defrauding the government and worked to conceal their pricing practices.
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