CVS, Omnicare accused of fraudulent billing for government programs

Omnicare, which has been in hot water before, provides pharmacy services to long-term care facilities.

The lawsuit alleges that from 2010 to 2018, instead of getting new prescriptions from patients’ doctors, Omnicare’s pharmacies just “rolled over” the prescriptions. (Photo: Shutterstock)

The Manhattan U.S. attorney has filed a civil health care fraud lawsuit against pharmacy service provider Omnicare, acquired by CVS Health Corp. in 2015.

According to Modern Healthcare, CVS and Omnicare were sued for fraudulently billing Medicare and other programs for drugs for older and disabled people without valid prescriptions. Omnicare, which has been in hot water before, provides pharmacy services to long-term care facilities. In this lawsuit, it’s accused of allowing its pharmacies to dispense prescription drugs to elderly and disabled residents even though prescriptions had expired or were out of refills.

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

The lawsuit alleges that from 2010 to 2018, instead of getting new prescriptions from patients’ doctors, Omnicare’s pharmacies just “rolled over” the prescriptions by automatically assigning a new prescription number, refills and prescription date. Then it billed Medicare, Medicaid and Tricare for the illegally dispensed drugs, which included antipsychotics, anticonvulsants and cardiovascular drugs and other medications.

The U.S. has intervened in two whistleblower lawsuits against Omnicare, and seeks treble damages and civil penalties.

Berman’s statement says in part, “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.” The Modern Healthcare report adds that Omnicare allegedly allowed prescriptions to roll over in at least 1,766 residential living facilities.

In a statement e-mailed to Modern Healthcare, a CVS Health spokesman said the claims had no merit, writing, “We are confident that Omnicare’s dispensing practices will be found to be consistent with state requirements and industry-accepted practices.”

Earlier suits included one in 2012 that resulted in the company paying $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, and in 2016 a $28.1 million settlement on allegations that it requested and accepted kickbacks from Abbott Laboratories to promote the drugmaker’s epilepsy drug to nursing home residents.

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