Ranitidine-based medications are generic versions of drugs with the brand-name Zantac®. They treat various gastrointestinal problems by reducing the amount of acid in the stomach. While lower-strength doses of ranitidine were available over the counter, high doses of 150 and 300 milligrams required a prescription. Ranitidine has been among the most popularly prescribed medications in the United States. Walgreens, CVS, Omnicare and other pharmacies dispensed tens of thousands of ranitidine prescriptions annually.

While ranitidine could be prescribed in multiple dosage forms, virtually all prescriptions were for tablets. Under federal and state laws, ranitidine tablets and capsules are different drugs. As different drugs, state Medicaid programs paid different prices for each drug to pharmacies filling Medicaid beneficiaries' prescriptions. The popular ranitidine tablets were subject to Medicaid price ceilings, while capsules were not. Allegedly, Walgreens, CVS and Omnicare overcharged Medicaid by dispensing the higher-priced capsules to Medicaid patients even though tablets had been prescribed. State pharmacy laws generally prohibit switching ranitidine capsules for tablets.