Wednesday, December 18, 2019

DOJ accuses CVS, Omnicare of fraudulently billing for illegally dispensed drugs

Shelby Livingston  December 17, 2019
The federal government accused pharmacy giant CVS Health and its Omnicare business of fraudulently billing federal health programs for hundreds of thousands of drugs dispensed without prescriptions.

In a civil healthcare fraud lawsuit filed Tuesday, the Manhattan U.S. attorney claimed that Omnicare, a provider of pharmacy services to long-term care facilities, violated the False Claims Act by allowing its pharmacies to dispense prescription drugs to elderly and disabled residents even though prescriptions had expired or were out of refills.

Omnicare then billed Medicare, Medicaid and Tricare for the illegally dispensed drugs, which included antipsychotics, anticonvulsants and cardiovascular drugs and other medications, the complaint alleged. The U.S. intervened in two whistleblower lawsuits against Omnicare. It is seeking treble damages and civil penalties.

"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," Manhattan U.S. Attorney Geoffrey Berman said in a statement.

From 2010 to 2018, instead of obtaining new prescriptions from patients' doctors, Omnicare pharmacies simply "rolled over" the prescriptions by automatically assigning a new prescription number, refills and prescription date, according to the complaint.

Continuing to dispense invalid prescriptions allowed Omnicare to fill more prescriptions and collect more revenue, while putting individuals living in residential facilities at risk by dispensing medications with dangerous side effects and that must be monitored by a doctor, according to the lawsuit. Omnicare allegedly allowed prescriptions to roll over in at least 1,766 residential living facilities.

A CVS Health spokesman said the claims had no merit. "We are confident that Omnicare's dispensing practices will be found to be consistent with state requirements and industry-accepted practices," he said in an emailed statement.

Omnicare, which was acquired by CVS in 2015 for $12.7 billion, has come under fire for its pharmacy practices before. In 2012, the company paid $50 million to settle U.S. Justice Department claims that its pharmacies had dispensed controlled substances to long-term care facility residents without valid prescriptions.
In 2016, Omnicare paid $28.1 million to settle allegations it requested and accepted kickbacks from Abbott Laboratories to promote the drugmaker's epilepsy drug to nursing home residents.

https://www.modernhealthcare.com/legal/doj-accuses-cvs-omnicare-fraudulently-billing-illegally-dispensed-drugs?utm_source=modern-healthcare-hits-wednesday&utm_medium=email&utm_campaign=20191218&utm_content=article6-readmore

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