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DMAHS directs pharmacies to submit claims to DMAHS using the MC-6 claim form. Every

time Omnicare submits a claim for reimbursement to Medicaid for a prescription it provides to a

Medicaid-funded patient, it uses the MC-6 form. This form contains a "Provider Certitication"

requiring signature, which states:

I certifY that the services covered by this claim were personally rendered by me or under my direct supervision and that the services covered by this claim and the amount charged thereof are in accordance with the regulations of the New Jersey Health Services Program; and that no part of the net amount payable under this claim has been paid; and that payment of such amount will be accepted as payment in full without additional charge to the patient or to others on his behalf. I understand that any false claims, statements or documents, or concealment of a material fact, may be prosecuted under applicable federal or State law, or both.

New Jersey Medicaid Pharmacy Services Fiscal Agent Billing Supplement.

191.

Likewise, in Illinois, at least once per day, when each Omnicare facility batches

its Medicaid claims and submits them electronically to IDHFS, as part of each electronic claim,

Omnicare affixes its unique Medicaid provider identification number, which serves as an

electronic stamp indicating that, as an Illinois Medicaid provider subject to the Provider

Agreement, Omnicare is in compliance with all applicable federal and state regulations. Claims

are adjudicated instantaneously; Omnicare receives reimbursement on a monthly basis by IDHFS

for all approved claims.

192.

Similar

electronic

or

"batched"

billing

systems

are

111

place

111

all states

participating in the Medicaid program.

193.

Omnicare certifies its compliance with all relevant statutes and regulations, state

and federal, upon application for a provider number, by using that provider number in submitting

a claim, and upon claim forms as a condition of payment. Omnicare's compliance with all

relevant state and federal statutes and regulations, including the AKS, is a condition that

determines whether Omnicare's claims to Medicaid are eligible for reimbursement as a matter of

54

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