Get 40% Off
⚠ Earnings Alert! Which stocks are poised to surge?
See the stocks on our ProPicks radar. These strategies gained 19.7% year-to-date.
Unlock full list

U.S. sues CVS for fraudulently billing Medicare, Medicaid for invalid prescriptions

Published 12/17/2019, 12:22 PM
Updated 12/17/2019, 12:22 PM
© Reuters. FILE PHOTO: Shoppers walk outside a CVS store and pharmacy in Medford

By Jonathan Stempel

NEW YORK (Reuters) - CVS Health Corp (N:CVS) and its Omnicare unit were sued on Tuesday by the U.S. government, which accused them of fraudulently billing Medicare and other programs for drugs for older and disabled people without valid prescriptions.

The Department of Justice joined whistleblower litigation accusing Omnicare of violating the federal False Claims Act for illegally dispensing drugs to tens of thousands of patients in assisted living facilities, group homes for people with special needs, and other long-term care facilities.

According to a civil complaint filed in Manhattan federal court, Omnicare would often assign new numbers to prescriptions after the original prescriptions expired or ran out of refills.

The government said this enabled Omnicare to bill Medicare Medicaid, and Tricare, which serves military personnel, for hundreds of thousands of drugs, under what the company internally called "rollover" prescriptions, from 2010 to 2018.

Many of the drugs were anticonvulsants, antidepressants and antipsychotics and treated serious conditions such as dementia, depression and heart disease, and sometimes had dangerous side effects requiring supervision by doctors, the government said.

"A pharmacy's fundamental obligation is to ensure that drugs are dispensed only under the supervision of treating doctors who monitor patients' drug therapies," 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," he added.

The lawsuit seeks civil penalties and other damages.

CVS, one of the largest U.S. drugstore chains and pharmacy benefit managers, said it did not believe the claims had merit, and that it intended to defend itself in court.

"We are confident that Omnicare's dispensing practices will be found to be consistent with state requirements and industry-accepted practices," the company said in a statement.

CVS, based in Woonsocket, Rhode Island, bought Omnicare in 2015 for about $10.4 billion.

The government joined a lawsuit originally brought in June 2015 by Uri Bassan, a pharmacist who worked for Omnicare in Albuquerque, New Mexico.

It said Omnicare's compliance department had acknowledged the dispensing problem internally two months earlier, when a regional officer expressed concern in an email that its systems allowed rollover prescriptions "without any documentation or pharmacist intervention."

The False Claims Act lets whistleblowers sue on behalf of the federal government, and share in recoveries.

Twenty-nine U.S. states and the District of Columbia are also named as plaintiffs.

© Reuters. FILE PHOTO: Shoppers walk outside a CVS store and pharmacy in Medford

The cases is U.S. ex rel. Bassan v. Omnicare Inc, U.S. District Court, Southern (NYSE:SO) District of New York, No. 15-04179.

Latest comments

Risk Disclosure: Trading in financial instruments and/or cryptocurrencies involves high risks including the risk of losing some, or all, of your investment amount, and may not be suitable for all investors. Prices of cryptocurrencies are extremely volatile and may be affected by external factors such as financial, regulatory or political events. Trading on margin increases the financial risks.
Before deciding to trade in financial instrument or cryptocurrencies you should be fully informed of the risks and costs associated with trading the financial markets, carefully consider your investment objectives, level of experience, and risk appetite, and seek professional advice where needed.
Fusion Media would like to remind you that the data contained in this website is not necessarily real-time nor accurate. The data and prices on the website are not necessarily provided by any market or exchange, but may be provided by market makers, and so prices may not be accurate and may differ from the actual price at any given market, meaning prices are indicative and not appropriate for trading purposes. Fusion Media and any provider of the data contained in this website will not accept liability for any loss or damage as a result of your trading, or your reliance on the information contained within this website.
It is prohibited to use, store, reproduce, display, modify, transmit or distribute the data contained in this website without the explicit prior written permission of Fusion Media and/or the data provider. All intellectual property rights are reserved by the providers and/or the exchange providing the data contained in this website.
Fusion Media may be compensated by the advertisers that appear on the website, based on your interaction with the advertisements or advertisers.
© 2007-2024 - Fusion Media Limited. All Rights Reserved.