Sometimes, Omnicare would make these switches with the physician's purported
permission - through the solicitation of a letter from the physician authorizing the switches.
However, as set forth herein, these letters (referred to in the trade as "Physician Authorization
Letters" or "PALs" ) were obtained under false pretenses.
Sometimes, however, Omnicare simply made the switch with no physician
oversight whatsoever. These switches, made with no care or concern for patient wellbeing -
many made for patients who had been stable on a particular medication for years - put patients'
health at risk and created the need for expensive collateral treatment, including testing and
monitoring. For Medicaid and other government-paid health care recipients, the cost of such
collateral care was borne by the government.
As a result of the kickbacks-for-switches scheme, payors were being billed for
medications different than those being prescribed.
The first kickbacks-for-switches scheme between Omnicare and a Defendant
Manufacturer was implemented in early 1998, with several following subsequently. They may
continue to this day.
Each Defendant Manufacturer took the following actions 111 furtherance of its
conspiracy with Omnicare to illegally switch patients from the medication prescribed to the
"bought and paid for" medication:
Makingfalse statements to Omnicare pont line pharmacy personnel as to the reason for the switching. Each Defendant Manufacturer made false representations to Omnicare pharmacy staff, through materials prepared uniqUely for Omnicare staff, through "kickoff' and other meetings designed to maximize the wholesale switching, and through
making themselves available for technical consultations. included:
These false representations
That the switch to its "preferred" medication was financially advantageous to the
government and private insurers, when this was almost never the case.