| TRENTON
- Attorney General Stuart Rabner announced
that New Jersey will receive over $300,000
as a result of a national Medicaid fraud
settlement with Omnicare, a corporation
which serves as a pharmacy for hospitals
and other institutions.
New
Jersey’s Medicaid program is to be
reimbursed $684,557, which will be split
by the state and federal government, with
the state receiving $333,263. The settlement,
which is subject to court approval, requires
Omnicare to pay over $49 million in civil
damages and penalties to the federal government
and state Medicaid programs across the country.
“In
these difficult fiscal times, this represents
a sizable sum that will be returned to the
State of New Jersey and will be available
to help our neediest citizens through the
Medicaid program,” said Attorney General
Rabner. “We have dedicated significant
resources to investigating and prosecuting
Medicaid fraud in New Jersey.”
“Every
dollar lost to fraud or abuse is one less
dollar available to help the most needy
citizens of our state,” said Insurance
Fraud Prosecutor Greta Gooden Brown. “The
Office of Insurance Fraud Prosecutor is
committed to fighting healthcare fraud and
returning much needed dollars to victims
of insurance fraud including Medicaid, insurance
companies and taxpayers.”
According
to Division of Criminal Justice Director
Gregory A. Paw, the Medicaid Fraud Control
Unit of the Office of Insurance Fraud Prosecutor
participated in a national investigation
of Omnicare as well as the negotiations
with the corporation. OIFP’s Medicaid
Fraud Control Unit routinely participates
in national settlements with the Department
of Justice through the National Association
of Medicaid Fraud Control Units.
The
$49.5 million represents overcharges by
Omnicare to the various states’ Medicaid
programs for prescription medications.
The
overcharges resulted from the fact that
Omnicare engaged in conduct that included
switching from brand name to generic drugs,
providing capsules instead of the equivalent
dosage in tablets, and providing some medicines
in two half-doses rather than one full dose.
Omnicare switched the prescription drugs
without notifying the prescribing physicians
that the switches were made, which violated
certain state pharmaceutical dispensing
regulations. The conduct by Omnicare allegedly
took place between January 2000 and 2005.
Of
the $49.5 million, the federal government
will receive $29,641,217 and the states
will receive $19,858,782.
The
Medicaid program, which is funded by the
state and federal governments, provides
health care services and prescription drugs
to persons who may not otherwise be able
to afford such services and medicines. The
State of New Jersey administers the Medicaid
program through the Division of Medical
Assistance and Health Services. The Office
of the Insurance Fraud Prosecutor’s
Medicaid Fraud Control Unit investigates
both criminal and civil Medicaid fraud and
abuse in that program.
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