request reimbursements for preferred medications that had not been prescribed.
Medicaid only pays for the prescribed drugs.
Any claim submitted or caused to
be submitted certifying entitlement to payment for a prescription drug dispensed without specific
physician authorization is a false claim.
concert with Omnicare, use PALs to
fraudulently obtain from the prescribing physicians blanket authority to switch prescriptions
from the originally prescribed medication to a medication that provides the Defendant
Manufacturers with the largest profit.
Valid "consent" cannot be obtained through fraud. The Defendant Manufacturers,
through the payment of kickbacks, improperly induced Omnicare to fraudulently solicit PALs.
Omnicare's solicitations for PALs routinely provide false, misleading, and incomplete
information to physicians. Moreover, the Defendant Manufacturers work in concert with
Omnicare to develop business plans, provide "educational" sales materials, and provide further
pressure via onsite sales staff designed to maximize the number of switches that Omnicare can
obtain through the fraudulent PAL solicitation schemes.
As is alleged in detail herein, when the Defendant Manufacturers and Omnicare
solicited PALs, the prescribing physicians were told that the preferred medications were more
etllcacious and that the switches would result in cost savings to the government health programs.
These statements were lies.
soliciting autllorization for the switches. Defendant Manufacturers and Omnicare intentionally
and materially failed to tell the prescribing physicians that the switches were done to create a
larger profit for the Defendant Manufacturers and thereby generate a kickback to Omnicare.