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  • VIII.

    THE DEFENDANT MANUFACTURERS ARE ALSO IN VIOLATION OF THE "REVERSE FALSE CLAIMS" PROVISIONS OF THE FEDERAL AND STATE FALSE CLAIMS ACTS

    • A.

      THE DEFENDANT MANUFACTURERS INTENTIONALLY MISREPORTED THE BEST PRICE FOR THE PREFERRED MEDICATIONS By CONCEALING THE OFF-INVOICE PRICE CUTS PROVIDED TO OMNICARE

229.

At all relevant times, the Defendant Manufacturers employed a range of strategies

to gain and maintain the lion's share of drugs sold by Omnicare to Medicaid beneficiaries within

their "preferred" medications' respective therapeutic classes.

230.

The

Defendant Manufacturers

knowingly

misrepresented,

by overstatement, the

lowest price ("best price") paid by Omnicare for their preferred medications in their mandatory

quarterly and annual reports submitted to the government, thereby intentionally misleading the

government agencies to believe Medicaid, FSS, and PHS/340b entites were receiving their

appropriate rebates and contract prices. Omnicare was in reality receiving a lower "best price"

than the price reported by the Defendant Manufacturers.

231.

At all relevant times, the Defendant Manufacturers knew and understood that the

net prices charged to Omnicare (the actual cost of the medications to Omnicare after the illegal

rebates) and other such private sector long-tenn care facilities were expressly required to be

included in the determination of "best price."

232.

Nevertheless,

the

Defendant Manufacturers

failed

to

submit

accurate best price

reports to the eMS on a quarterly basis since their Market Share Agreements with Omnicare

went

into

effect.

Defendant

Manufacturers'

best

price

reports

routinely

submitted

to

the

government were materially false in that they purposefully excluded the net prices charged to

Omnicare for the Defendant Manufacturers' "preferred" medications.

233.

Defendant Manufacturers are required by law to use their best price calculations

63

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