Md.'s Medicaid Nets $343,176 from Pharmacy Alleged to Have Defrauded Program


ANNAPOLIS - Maryland Attorney General J. Joseph Curran, Jr. announced today that the Maryland Medicaid Program received a payment of $167,068 as its share of a nationwide settlement entered into by Omnicare, Inc. Counting the federal share of Medicaid payments in Maryland, the total value of the settlement to the Maryland Medicaid program was $343,176. Medicaid is a national program to pay health care expenses of certain low income families and individuals.

Omnicare is an institutional pharmacy that does business in 47 states and has its corporate offices in Covington, Kentucky. The payment to the Maryland Medicaid program is part of a $ 49.5 million settlement to resolve claims raised in two separate law suits filed in federal court by two former Omnicare employees. Omnicare paid $29.6 million directly to the federal government which represents its share of the money improperly obtained from the Medicaid program and $19.9 million collectively to the 43 states affected by Omnicare’s schemes.

Those employees allege that between April 2000 and December 2005 Omnicare improperly switched its Medicaid patients who were prescribed ranitidine, which is generic Zantac, from tablets to capsules in order to avoid payment limits that had been imposed on the tablet form by the federal government (in this case similar payment limits were NOT imposed on the capsules.) As a result Omnicare obtained higher payments from Medicaid than it was entitled to receive.

Omnicare was also alleged to have engaged in a similar switching scheme for Medicaid patients who had been prescribed fluoxetine, generic Prozac, except the switch was from capsules to tablets. Finally, Omnicare was alleged to have switched Medicaid patients who were prescribed busiprone, which is generic Buspar, from the 15 mg does to two 7.5 mg doses in order to obtain higher reimbursement from the Medicaid programs. These switches were done without the approval of the patients’ physicians and were not medically necessary.

Omnicare has also entered into a corporate integrity agreement with the Office of the Inspector General of the United States Department of Health and Human Services which subjects it to increased monitoring and scrutiny by the Inspector General. Omnicare did not admit liability as part of the settlement.

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