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law.

194.

Omnicare therefore makes certified representations and claims to the government

seeking Medicaid reimbursement for pharmaceuticals on a daily basis. One of the certified

representations Omnicare makes in each of its claims submitted to the government is that the

claim is submitted in compliance with the AKS.

195.

As a result of, and in reliance on, these certified claims, state Medicaid programs

pay for Defendant Manufacturers' drugs.

VII.

THE DEFENDANT MANUFACTURERS CAUSED FALSE CLAIMS TO BE SUBMITTED FOR THEIR PREFERRED MEDICATIONS IN VIOLATION OF THE FEDERAL AND STATE FALSE CLAIMS ACTS

196.

The

Defendant

Manufacturers

have

caused

the

submission

of

false

claims,

records, and statements to the Medicaid program for their preferred medications pursuant to

unlawful Market Share Agreements with Omnicare. The kickbacks-for-switches scheme gives

rise to Defendant Manufacturers' liability under the Federal and State False Claims Acts by:

  • (a)

    causing the submission of claims requesting reimbursements for drugs that had not been validly prescribed, on the basis of prescriptions that could not be validly filled;

  • (b)

    causing the submission of claims requesting reimbursements for drugs that were selected on the basis of maximum profit, without any medical basis;

and,

(c)

causing the submission of claims that contained a false certification that they had been submitted in compliance with the law. The government conditioned payment of these claims upon this certification.

A.

THE KICKBACKS-FOR-SWITCHES SCHEME AND ACCOMPANYING PAL SOLICITATIONS CREATED FALSE CLAIMS

197.

The

Defendant

Manufacturers

caused

the

submission

of

false

and

fraudulent

claims by paying illegal kickbacks to Omnicare to induce Omnicare to fill prescriptions and

55

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