Failing to disclose kickbacks and other financial interests to physicians in helping Gmnicare solicit PALs. Each Defendant Manufacturer failed to disclose to physicians that it was providing kickbacks to Omnicare for switching certain types of medications to "preferred" medications.
Requiring Gmnicare to develop computerized electronic capability to accurately track levels ofparticipation in the illegal PAL solicitation program by site and by prescribing clinician.
That its "preferred" medication was clinically the most appropriate drug within
the therapeutic class for every patient, when frequently this, too, was not the case.
Making false statements to physicians as to the reasons for the switching.
nursing homes to work with Omnicare consultant sign PALs authorizing wholesale switches.
Rewarding Gmnicare for the proportion ofpatients switched to its preferred medication via illegal switching payments based in patt on the success of the switching scheme.
Defendant Manufacturers could not provide medications directly to the Medicaid
program or issue prescriptions for their medications. Instead, their unlawful conduct knowingly
caused Omnicare and other pharmacies to submit thousands of Medicaid claims for defendants'
medications that were not eligible for Medicaid reimbursement.
Omnicare to illegally switch patients' medications would cause Omnicare to submit false claims
to the federal and state governments. Relator, in the name of the United States and other plaintiff
States as detailed herein, seeks to hold the Defendant Manufacturers liable for kuowingly
causing false claims to be presented for payment and for conspiring with Omnicare to present
FurthelIDore, Defendant Manufacturers, as a precondition for participating in the
Medicaid program, are obligated to report to the govermnent the lowest price they give any
customer for every medication. This is known as the "best price."