by Paige Minemyer | Dec 17, 2019 11:54am
The
federal government has joined a lawsuit alleging Omnicare, a subsidiary of CVS
Health, fraudulently billed Medicare, TRICARE and Medicaid for thousands of
drugs.
The
Department of Justice on Tuesday joined the whistleblower suit (PDF)
that charges Omnicare dispensed hundreds of thousands of drugs to elderly
patients at thousands of long-term care facilities between 2010 and
2018.
Omnicare is
the nation’s largest pharmacy provider for such facilities. CVS
acquired the company in 2015.
“Omnicare, and its parent company CVS, allowed
Omnicare pharmacies to dispense prescription drugs indefinitely to individuals
living in these residential facilities based on prescriptions that had expired,
were out of authorized refills, or were otherwise invalid,” DOJ said in the
complaint.
Omnicare
ignored prescription refill limits and expiration dates, according to the suit,
and instead continued to provide the drugs based on outdated prescriptions.
Heeding the expirations would have launched a consult with a patient’s
physician, which would review whether the prescription should be
renewed, DOJ said.
In a
statement to FierceHealthcare, a spokesman for CVS Health said the
healthcare giant is “confident that Omnicare’s dispensing practices will be
found to be consistent with state requirements and industry accepted
practices.”
“We do
not believe there is merit to these claims, and we intend to
vigorously defend the matter in court,” said Mike DeAngelis, senior director of
corporate communications.
The DOJ
alleges that Omnicare allowed expired prescriptions to roll over for residents
in at least 1,766 long-term care facilities. At an additional 1,476 locations,
Omnicare used its automated “cycle fill” system to automatically fill these
prescriptions, according to the lawsuit.
Omnicare
has been investigated before on similar charges, DOJ said, and the company has
been the subject of “numerous” federal investigations and lawsuits in the
past—a number of which were concluded with substantial settlements.
For
example, in 2012, Omnicare paid a $50 million settlement to DOJ on similar
charges that it dispensed drugs on invalid prescriptions.
Internal
audits have also flagged a lack of renewal reviews conducted by physicians as a
“recurring issue,” DOJ said.
“Senior
management at Omnicare and CVS knew Omnicare’s pharmacies were routinely
dispensing drugs without valid prescriptions,” DOJ said in the complaint. “But
they failed to begin to address the problem until they found out Omnicare was
being investigated again, this time by this Office.”
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