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254.

Insurers which reimbursed Omnicare for drugs during the time of this complaint

include, but are not limited to: United Healthcare, Blue Cross/Blue Shield, Health Alliance,

Humana, Aetna, and HMO Illinois.

255.

In order to obtain reimbursement from insurers for services provided, Omnicare

typically would submit electronically a form describing the services, the service date, the total

charges

and

non-covered

charges,

if

any.

Omnicare

would

typically

submit

these

bills

for

reimbursement

on

a

daily

basis.

These

bills

would

contain

various

certifications

and/or

verifications, including that the claim for reimbursement is correct and complete, and a warning

that anyone who misrepresents or falsifies material information requested by the form may be

subject to fine or imprisonment under state law.

256.

Omnicare

submitted

electronic

claims

or

bills

to

insurers

for

the

prescription

drugs, including but not limited to Monopril, Lipitor, Accupril, Levaquin, Risperdal,

UltramlUltracet, and Abilify. As a result of their conspiracy with Defendant Manufacturers,

Omnicare billed insurers for such drugs even though claims for the drugs were based on

kickbacks, the drugs were unilaterally switched without a properly authorized physician's

prescription,

and

despite

other

misrepresentations

and

omissions.

Such

claims

for

drugs

dispensed as a result of the kickbacks-for-switches schemes contained false, incomplete, or

misleading information concerning facts material to the claims.

257.

Omnicare never informed insurers that they were paying kickbacks as part of a

conspiracy to evade best price obligations, or that they conspired to and did switch drugs without

a physician's informed authorization.

258.

By causing the concealment of these policies and practices, while knowing that

Omnicare was then submitting claims to insurers for payment, Defendant Manufacturers

68

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