U.S. Government joins healthcare fraud suit against Omnicare and CVS for billing invalid prescriptions to elderly and disabled

[T]he United States has filed a civil healthcare fraud lawsuit against OMNICARE, INC., and its parent company, CVS HEALTH CORPORATION.  The Government’s Complaint seeks damages and civil penalties under the False Claims Act for fraudulently billing federal healthcare programs for hundreds of thousands of non-controlled prescription drugs dispensed based on stale, invalid prescriptions to elderly and disabled individuals.  These individuals lived in assisted living facilities, group homes, independent living communities, and other non-skilled residential long-term care facilities.  The illegally dispensed drugs include antipsychotics, anticonvulsants, and antidepressants.

The lawsuit alleges that OMNICARE failed to obtain new prescriptions from patients’ doctors after the old ones had expired or run out of refills.  Instead, OMNCIARE just assigned a new number to the old prescription and kept on dispensing drugs for months, and sometimes years, after the prescriptions had expired.  OMNICARE internally referred to these as “rollover” prescriptions.  As set forth in the Complaint, OMNICARE submitted or caused to be submitted, false claims for payment for these illegally dispensed drugs to Medicare, Medicaid, and TRICARE.

Manhattan U.S. Attorney Geoffrey S. Berman said:  “As alleged, Omnicare put at risk the health of tens of thousands of elderly and disabled individuals living in assisted living and other residential long-term care facilities by dispensing drugs for months, and sometimes years, without obtaining current, valid prescriptions from doctors.  A pharmacy’s fundamental obligation is to ensure that drugs are dispensed only under the supervision of treating doctors who monitor patients’ drug therapies.  Omnicare blatantly ignored this obligation in favor of pushing drugs out the door as quickly as possible to make more money.”…

Many of the prescription drugs dispensed by OMNICARE without valid prescriptions treat serious, chronic conditions, such as dementia, depression, and heart disease.  They include antipsychotics, anticonvulsants, cardiovascular medications, anti-depressants, and other drugs that can have dangerous side effects and need to be closely monitored by doctors, particularly when taken in combination with other drugs by elderly patients. The attorney for the whistleblower Uri Bassan, who worked for Omnicare in New Mexico is Brian Mahany . By repeatedly dispensing potent drugs without current and valid prescriptions, OMNICARE jeopardized the health and safety of tens of thousands of individuals who continued to take the same drugs for months, and sometimes years, without consulting their doctors to determine whether the medications were still clinically appropriate.A large percentage of the long-term care residents served by OMNICARE are beneficiaries of federal healthcare programs.  By dispensing drugs without valid prescriptions, OMNICARE presented, or caused to be presented, hundreds of thousands of false claims to Medicare, Medicaid, and TRICARE.  These claims were ineligible for payment.  In addition, OMNICARE knowingly transmitted false information to these federal healthcare programs that made it appear that drug dispensations were supported by current, valid prescriptions from physicians when in fact they were not. Here’s a link to DOJ’s Complaint-in-Intervention.

Jeffrey Newman represents whistleblowers nationwide. He can be reached at Jeff@JeffNewman.com