Omnicare Inc. to pay $49.5 million for Medicaid prescription drug fraud
Healthcare Auditing Weekly, December 11, 2007
Omnicare, Inc. will pay the government and 43 states $49.5 million to settle a case initiated by two whistleblowers. Omnicare allegedly switched Medicaid patients from a cheaper version of three drugs (generic Zantac, Prozac, and Buspar) in order to increase its reimbursement rate.
Some of the changes were allegedly made by Omnicare:
- without informing the prescribing doctor of the change in drug form
- after telling the physician the new version of the drug would be cheaper for the payer
- after suggesting that the patient would benefit from the new drug
As part of the settlement, Omnicare entered into a five year compliance agreement with the Department of Health and Human Services to prevent drug switches like this in the future.
This case is the first time that a United State's Attorney's office has teamed up with the National Association of Medicaid Fraud Control Units. Inspector General Levinson of HHS said, "We will continue to work closely with Medicaid Fraud Control Units around the country to investigate and prosecute those who engage in schemes to illegally profit from and defraud the Medicaid program at the expense of vulnerable beneficiaries."
To read more click here
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: Flu shot requirement for hospital employees
- Running an effective peer review committee meeting
- HealthDataInsights posts new issues for medical necessity claims
- Sneak Peek: Effort underway to establish caseload benchmarks
- Q/A: Coding for telescopic intraocular lens
- New FAQ posted on storing laryngoscope blades
- Tip: Perform your own internal investigation prior to government audit
- HIPAA 5010 deadline extended, but threat remains, says AMA
- HHS task force: Consider privacy, security with text messages
- What does case-mix index mean to you?
- E-mailed
-
- Running an effective peer review committee meeting
- HIPAA Q&A: Flu shot requirement for hospital employees
- HHS task force: Consider privacy, security with text messages
- What does case-mix index mean to you?
- Q/A: Coding for telescopic intraocular lens
- Q/A: Correct use of modifier -PT
- Tip: Correctly code bilateral pain management procedures
- "Wall fountains" may be spreading Legionnaires to patients, visitors
- 2012 CPT code changes for ASCs: Shoulder and knee scopes and pain management
- Case Management Monthly, March 2012
- Searched