WOONSOCKET – The U.S. Attorney for the Southern District of New York has filed a lawsuit against Omnicare Inc. and its parent CVS Health Corp., alleging that Omnicare fraudulently billed federal health care programs for hundreds of thousands of noncontrolled prescription drugs, the U.S.Department of Justice announced on Tuesday.
The lawsuit claims that Omnicare billed and dispensed drugs to elderly and disabled individuals based on “stale, invalid prescriptions,” including antipsychotics, anticonvulsants and antidepressants. The DOJ claims that the company failed to obtain new prescriptions from patients’ doctors when prescriptions had expired or run out of refills, and asserted that the company reassigned a new number to the old prescription and continued to dispense drugs for months or years after prescriptions had expired.
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CVS bought Omnicare in 2015. The lawsuit claims the violations extended from 2010 to 2018 and alleges that both senior Omnicare and CVS management knew its pharmacies were dispensing drugs without valid prescriptions.
CVS refuted the charges in the lawsuit in a statement, saying, “We do not believe there is merit to these claims and we intend to vigorously defend the matter in court. We are confident that Omnicare’s dispensing practices will be found to be consistent with state requirements and industry-accepted practices.”
The practice, which the lawsuit claims the company internally called “rolling over” a prescription, was also said to have included, in some instances, assigning a fake number of authorized prescriptions to ensure continuous refilling.
The U.S. Attorney’s Office said that the company was aware of the practice “but they failed to begin to address the problem until after they found out about” an investigation by the U.S. Attorney’s Office for the Southern District of New York.
The lawsuit noted that expired prescriptions should trigger doctor visits to evaluate whether the drug should be renewed.
The DOJ alleged that Omnicare’s managers “exerted pressure on overwhelmed pharmacy staff to fill prescriptions as quickly as possible,” so that the company could submit claims and collect payments.
“A pharmacy’s fundamental obligation is to ensure that drugs are dispensed only under the supervision of treating doctors who monitor patients’ drug therapies,” said Manhattan U.S. Attorney Geoffrey S. Berman in a statement. “ Omnicare blatantly ignored this obligation in favor of pushing drugs out the door as quickly as possible to make more money.”
The DOJ has sued for damages and civil penalties, claiming the company submitted “hundreds of thousands of false claims to Medicare, Medicaid and TRICARE. It also claimed that Omnicare “knowingly transmitted false information” to the federal programs to make it appear that drug dispensations were supported by current and valid prescriptions.
The charges were filed under the False Claims Act. The DOJ said that the government had intervened in two private whistleblower lawsuits that had previously been filed under seal.
Chris Bergenheim is the PBN web editor. You may reach him at Bergenheim@PBN.com.
