Ahold Delhaize USA to Pay $40 Million in Drug Price Claims Settlement
Key Takeaways
- Ahold Delhaize USA agreed to pay $40 million to resolve allegations that its supermarket pharmacies reported inflated usual and customary prescription drug prices to Medicare Part D, Medicaid, and TRICARE.
- Federal prosecutors alleged that discounted prices offered through pharmacy savings programs were not properly reported, resulting in higher reimbursements from government health care programs.
- The settlement resolves False Claims Act allegations brought by a whistleblower pharmacist and participating governments, although the company did not admit liability and there was no determination of wrongdoing.
Ahold Delhaize USA Inc has agreed to pay $40 million to resolve allegations that it violated the False Claims Act and related state laws by reporting inflated “usual and customary” prescription drug prices on claims submitted to federal health care programs.
The settlement resolves allegations involving claims submitted to Medicare Part D, Medicaid, and TRICARE. The US Department of Justice (DOJ) alleged that Ahold Delhaize supermarkets with in-store retail pharmacies—including banners such as Giant, Hannaford, Stop & Shop, Food Lion, and others—operated prescription savings programs that offered discounted prices to enrolled members.
Allegations Involving Usual and Customary Prices
According to the government, the discounted prices available through those prescription savings programs should have been reported as the pharmacies’ “usual and customary” prices when claims were submitted to Medicare Part D, Medicaid, and TRICARE.
The DOJ stated that reported usual and customary prices serve as ceiling prices under applicable health care program payment formulas. Federal officials alleged that Ahold Delhaize pharmacies failed to accurately report the discounted savings-program prices as usual and customary prices, causing federal health care programs to pay inflated amounts on certain prescription claims.
Settlement Breakdown
Of the $40 million settlement, $32.9 million represents the federal share. The remainder will be paid to states participating in the settlement. Medicaid is jointly funded by the federal government and states, which accounts for the state share of the recovery.
The civil settlement also resolves claims brought under the qui tam, or whistleblower, provisions of the False Claims Act. The whistleblower, Lawrence LaBenne, was a pharmacist at an Ahold Delhaize supermarket in Pennsylvania. He will receive $6 083 587 from the federal share of the settlement.
Federal Enforcement Focus
The DOJ said the settlement reflects continued federal attention on health care fraud enforcement and accurate pharmacy pricing submissions. Federal officials emphasized that health care programs rely on pharmacies to report truthful pricing information used in reimbursement formulas.
The matter involved the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the US Attorney’s Office for the Western District of Pennsylvania, with assistance from the Department of Health and Human Services, the Defense Health Agency, and state Medicaid programs.
The claims resolved by the settlement are allegations only. There has been no determination of liability.
Pharmacy Practice Implications
For pharmacists, the case highlights the compliance risks associated with prescription discount programs and the reporting of usual and customary prices. While the allegations were directed at the corporate entity rather than individual pharmacists, pharmacy personnel are often responsible for implementing pricing programs, processing claims, and ensuring that reimbursement submissions accurately reflect pharmacy pricing practices.
The settlement also underscores ongoing government scrutiny of pharmacy reimbursement and usual and customary pricing methodologies, an area that has generated enforcement actions across multiple pharmacy operators in recent years. Pharmacists working in community, supermarket, and chain pharmacy settings may want to be familiar with their organization's policies governing discount programs, cash pricing, and third-party billing to help ensure compliance with federal and state reimbursement requirements.
References
- Office of Public Affairs. Ahold Delhaize USA Inc. to pay $40M for allegedly reporting inflated drug prices on claims to federal healthcare programs. US Department of Justice. Press Release. June 10, 2026. Accessed June 16, 2026. https://www.justice.gov/opa/pr/ahold-delhaize-usa-inc-pay-40m-allegedly-reporting-inflated-drug-prices-claims-federal
- Vimal S. Ahold Delhaize USA to pay $40m over inflated drug pricing claims. Yahoo!Finance. June 12, 2026. Accessed June 16, 2026. https://finance.yahoo.com/sectors/healthcare/articles/ahold-delhaize-usa-pay-40m-093014788.html
