Omnicare, Inc. Agreed to a $124 Million Settlement to Resolve Whistleblower Claims Concerning an Alleged Swapping Scam Involving Below Cost Discounts and Medicare and Me

The Department of Justice announced in late June that it settled with Omnicare, Inc. concerning at least one qui tam whistleblower case involving allegations over kickbacks from discounts offered to skilled nursing homes for Medicare and Medicaid patients. The scheme was put in place to encourage facilities to choose Omnicare as their pharmacy provider.

Port Washington, NY (PRWEB) July 18, 2014

Parker Waichman LLP, a national law firm that has long been dedicated to protecting the rights of victims who have been defrauded due to unethical behaviors, reports that at least one of two whistleblower cases that were brought over allegations of swapping schemes have been settled for what is believed to be the largest settlement over these types of cases, to date. The cases involved are United States ex rel. Gale v. Omnicare, Inc., 1:10-cv-00127-JG, U.S. District Court, Northern District of Ohio, (Cleveland), filed on October 24, 2013 and United States ex rel. Silver v. Omnicare, Inc., et al., Case No. 1:11-cv-01326-NLH, filed September 19, 2013, in the United States District Court, District Of New Jersey.

According to a release issued by the Department of Justice, Office of Public Affairs on June 25, 2014, the alleged scheme involved nursing homes that were also Medicare and Medicaid participating providers. Under the scheme, the facilities filed reimbursement claims for short-term rehabilitation treatment received by patients for Medicare. Concurrently, Omnicare submitted additional claims to Medicare and Medicaid for the drugs it provided. A former Omnicare pharmacy manager brought the whistleblower case in 2010.

The settlement resolves allegations brought in the lawsuits filed by whistleblowers under the qui tam provisions of the False Claims Act over federal claims concerning per diem contracts, according to the Department of Justice. The state per diem claims are being handled in a whistleblower lawsuit pending in the United State District Court, District of New Jersey (United States ex rel. Silver v. Omnicare, Inc., et al., Case No. 1:11-cv-01326-NLH, filed September 19, 2013). This lawsuit also alleges that Omnicare was involved in other kickbacks related to fee-for-service contracts.

This whistleblower lawsuit, once settled, will provide the whistleblower, former Omnicare pharmacist Donald Gale, with more than $17 million. The states, which jointly funded the Medicare and Medicaid programs impacted by the alleged Omnicare misconduct will receive $8.24 million of the settlement. The federal government will receive the remainder. (United States ex rel. Gale v. Omnicare, Inc., 1:10-cv-00127-JG, U.S. District Court, Northern District of Ohio, (Cleveland), filed on October 24, 2013)

Whistleblowers are crucial to stopping illegal employer activities that may harm citizens and which may also defraud the government and other entities. What many may not realize is that, under certain circumstances, whistleblowers may also maintain their anonymity during much of the whistleblower process, notes Parker Waichman LLP.

The False Claims Act enables private persons to file lawsuits that may provide the government with details that concern such wrongdoings. Under the statute, if it is established that a person knowingly submitted and/or caused others to submit false or fraudulent claims to the United States, the U.S. government may then recover treble damages, Parker Waichman LLP also pointed out. Additional monies may also be received for every statute that has been violated. Should the government successfully resolve or litigate its claims, the whistleblower who initiated the action may also receive a significant portion of the recovered amount.

According to the Justice Department, the Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving compensation to persuade referrals of items or Medicare- and Medicaid-covered, and other federally funded, programs. The Anti-Kickback Statute is meant to ensure that the selection of health care providers and suppliers is not impacted by inappropriate financial incentives and is, rather, based on the patient’s best interests.

Parker Waichman LLP offers free legal consultations to victims of injuries allegedly caused by medical devices and also offers free legal consultations to potential whistleblowers. If you believe that your company is involved in illegal activities, please visit the Whistleblower page at YourLawyer.com or call 1-800-LAW-INFO (1-800-529-4636).


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