CVS ordered to pay $949m over invalid prescriptions in federal lawsuit
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Uri Bassan, a former Omnicare pharmacist in Albuquerque, N.M., first filed the suit in 2015. The US Department of Justice joined the suit in 2019. Both parties accused Omnicare of improperly billing Medicare, Medicaid, and Tricare prescriptions for patients in assisted-living communities, group homes, and other long-term care facilities without valid prescriptions.
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CVS plans to appeal.
'This lawsuit centered on a highly technical prescription dispensing record keeping issue that was allowed by law in many states,' said Ethan Slavin, a spokesman for CVS, in a statement to the Globe on Thursday. 'The dispensing practices referenced were limited to Omnicare, ended in 2018, were used by many others in the industry at the time.'
Slavin said the practices were accepted by the federal Centers for Medicare & Medicaid Services.
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Slavin said there was no claim in the case that 'any patient paid for a medication they shouldn't have or that any patient was harmed.'
A jury
'False claims in the healthcare industry cost every American,' said US Attorney Jay Clayton
The False Claims Act allows whistleblowers to bring complaints on the federal government's behalf. The law is key for the government to combat fraud. The law requires tripling of damages, which inflated CVS' penalty. But the company argues the award violates the Constitution's barring of excessive fines.
'The decision on penalties is unconstitutional, especially given the fact that there is no evidence that a single patient suffered harm,' said Slavin. 'We plan to appeal once the judgment is entered.'
In 2024, CVS Health reported
McMahon wrote in her order that while the fine 'is a very big number,' this 'was a very big fraud on the government, one that lasted over almost a decade, and that Omnicare was aware of but avoided taking steps to correct.'
Alexa Gagosz can be reached at
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