Covington, Ky.-based Omnicare, the largest provider of pharmaceutical care for nursing home patients, has agreed to pay $21 million to settle allegations that the company overbilled the Michigan and Massachusetts Medicaid programs, according to a Cincinnati Enquirer news report.
The settlement is the result of a whistleblower case filed in Chicago in 2003 by a former Omnicare financial analyst. In one instance, the whistleblower's complaint accused that Omnicare's North Shore Pharmacy in Massachusetts was paid an average $27.75 per prescription by private insurers, while payments for Medicaid patients averaged $47.15 per prescription. Pricing regulations require companies to bill Medicare the lowest price it charges private third-party payors for the same drug, according to the report.
Under the settlement, Omnicare will pay $11.6 million to Michigan and $9.45 million to Massachusetts and is required to comply with pricing regulations. Additionally, under the settlement agreement a pending lawsuit in Ohio against the company has been dismissed. Omnicare is denying any wrongdoing in these cases, according to the report.
Read the Cincinnati Enquirer's report about Omnicare's settlement.
Read other coverage about healthcare fraud involving OmniCare:
-Two Atlanta-Based Nursing Home Chains Settle False Claims Allegations for $14M
- Nation's Largest Nursing Home Pharmacy and Drug Manufacturer Settles False Claims Allegations for $112M
The settlement is the result of a whistleblower case filed in Chicago in 2003 by a former Omnicare financial analyst. In one instance, the whistleblower's complaint accused that Omnicare's North Shore Pharmacy in Massachusetts was paid an average $27.75 per prescription by private insurers, while payments for Medicaid patients averaged $47.15 per prescription. Pricing regulations require companies to bill Medicare the lowest price it charges private third-party payors for the same drug, according to the report.
Under the settlement, Omnicare will pay $11.6 million to Michigan and $9.45 million to Massachusetts and is required to comply with pricing regulations. Additionally, under the settlement agreement a pending lawsuit in Ohio against the company has been dismissed. Omnicare is denying any wrongdoing in these cases, according to the report.
Read the Cincinnati Enquirer's report about Omnicare's settlement.
Read other coverage about healthcare fraud involving OmniCare:
-Two Atlanta-Based Nursing Home Chains Settle False Claims Allegations for $14M
- Nation's Largest Nursing Home Pharmacy and Drug Manufacturer Settles False Claims Allegations for $112M