Nationwide pharmacy Omnicare Inc. will pay $2.24 million to settle whistleblower allegations that it improperly billed federal healthcare programs.
According to a press release by the Department of Justice, Omnicare was accused of manually altering the National Drug Code field on claims submitted to federal healthcare programs like Medicare, Medicaid and TRICARE.
The allegations say the claims at issue had been previously denied at least once, and Omnicare had resubmitted them with altered codes in hopes of getting them approved.
Omnicare was purchased by CVS Health Corp. in 2015. Though the alleged conduct occurred from 2006 to 2014, CVS Health will take on responsibility under this whistleblower settlement agreement.
In addition to payment of financial penalties, CVS Health will enter into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General.
The agreement is designed to prevent future fraud and abuse in CVS Health’s institutional pharmacy operations by increasing transparency and accountability.
The settlement does not require Omnicare or CVS Health to admit liability.
In the company’s own statement, CVS says it agreed to the settlement solely to avoid the expense and uncertainty of future litigation.
The company also notes no allegations have been made pertaining to any of its other businesses.
This whistleblower settlement originated with a False Claims Act lawsuit originally filed in March 2015 by Darlene E. a former Omnicare Regional Servicer Area Director from California.
Darlene says she became aware of the improper billing around September 2012.
In one audit report covering six months’ worth of data, Darlene estimated she found at least $4.25 million in questionable claims.
Darlene filed the whistleblower lawsuit on behalf of the federal government, the District of Columbia and 26 states.
The Department of Justice intervened solely for purposes of securing the settlement agreement.
As an incentive for bringing the action, Darlene will receive a share in the recovered funds of over $411,000.
Other Allegations of Fraud Against Federal Healthcare Programs
This whistleblower settlement was announced just two days after the DOJ announced an even larger False Claims Act settlement linking Omnicare to pharmaceutical manufacturer Abbott Laboratories.
In that settlement, Omnicare agreed to pay over $28 million to resolve allegations it solicited and received kickbacks from Abbott Laboratories in exchange for promoting Abbott’s drug Depakote for nursing home patients.
The government’s allegations say Abbott disguised its kickbacks to Omnicare as “grants” and “educational funding.”
Omnicare allegedly solicited kickbacks in the guise of donations that would fund educational programs, when in fact those payments were solely a quid-pro-quo exchange for pushing Depakote, according to the DOJ.
“Kickbacks to entities making drug recommendations compromise their independence and undermine their role in protecting nursing home residents from the use of unnecessary drugs,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Department of Justice’s Civil Division.
About $7.8 million of the settlement amount will go to fund state claims under certain federal healthcare programs.
This settlement is the culmination of two separate False Claims Act lawsuits filed by Richard S. and Meredith M., two former Abbott employees.
Meredith will receive a $3 million share of the recovered funds. The DOJ did not report the size of the share, if any, that Richard will receive.
In general, whistleblower and qui tam lawsuits are filed individually by each plaintiff and are not class actions. Whistleblowers can only join this investigation if they are reporting fraud against the government, meaning that the government must be the victim, and that the alleged fraud should be a substantial loss of money.
Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual qui tam lawsuit or whistleblower class action lawsuit is best for you. Hurry — statutes of limitations may apply.
ATTORNEY ADVERTISING
Top Class Actions is a Proud Member of the American Bar Association
LEGAL INFORMATION IS NOT LEGAL ADVICE
Top Class Actions Legal Statement
©2008 – 2026 Top Class Actions® LLC
Various Trademarks held by their respective owners
This website is not intended for viewing or usage by European Union citizens.
Get Help – It’s Free
Join a Free Whistleblower, Qui Tam Lawsuit Investigation
If you believe that you have witnessed fraud committed against the government, you may have a legal claim. Whistleblowers can only join this investigation if they are reporting fraud against the government, meaning that the government must be the victim, and that the alleged fraud should be a substantial loss of money.
See if you qualify to pursue compensation and join a whistleblower lawsuit investigation by submitting your information for a free case evaluation.
An attorney will contact you if you qualify to discuss the details of your potential case.
Please Note: If you want to participate in this investigation, it is imperative that you reply to the law firm if they call or email you. Failing to do so may result in you not getting signed up as a client, if you qualify, or getting you dropped as a client.
Oops! We could not locate your form.
