A New York judge has ordered CVS Health's Omnicare subsidiary to pay $948.8 million in fees and damages as part of a False Claims Act whistleblower case.
In April, a federal jury determined that Omnicare submitted more than 3.3 million fraudulent claims for prescriptions between 2010 and 2018, which led to $135.6 million in overpayments from the government.
The jury ruled that CVS Health, which acquired Omnicare in 2015, incentivized the unit to submit more than 1 million of those claims after the merger closed. However, the jurors determined that there was no injury to the federal government related to those claims.
Given the volume of claims in the mix, the government requested $542 million in penalties against the company. In addition, Omnicare was hit with $406.8 million in damages, far higher than the $135.6 million set by the jury earlier this year.
The damages were tripled as per requirements under the False Claims Act, according to the order.
"Admittedly, that is a very big number," District Judge Colleen McMahon wrote in the order. "But this is a very big fraud on the government, one that lasted over almost a decade, and one that Omnicare was aware of but avoided taking steps to correct."
The lawsuit was first filed in 2015 by a former Omnicare pharmacist, and the Department of Justice joined the whistleblower case in 2019. Omnicare provides pharmacy services to long-term care facilities.
In a statement to Fierce Healthcare, a spokesperson for CVS said the company intends to appeal the penalties as "the decision on penalties is unconstitutional, especially given the fact that there is no evidence that a single patient suffered harm."
"This lawsuit centered on a highly technical prescription dispensing record-keeping issue that was allowed by law in many states," the spokesperson said. "The dispensing practices referenced were limited to Omnicare, ended in 2018, were used by many others in the industry at the time, and were accepted by CMS."
"There was no claim in this case that any patient paid for a medication they shouldn’t have or that any patient was harmed," they said.
In the order, McMahon pushed back on CVS's argument that the penalties are unlawful.
"The violations in this case were both deliberate and egregious," she wrote. "Omnicare was aware of the problems posed by its dispensing practices; it was warned again and again, both by employees and by outside (State) regulators."
"Of great significance, Omnicare actually developed fairly straightforward means of resolving those problems but declined to implement them for years," she said.