Simmer says long-term care facilities typically contract with institutional pharmacies like Omnicare to provide not only special packaging for controlled administration, but also consultation services for physicians and in-service training programs for nursing staff. The company receives millions of dollars annually in reimbursement from the federal Medicare Part D program as well as from Medicaid, which is jointly funded by the federal and state governments.
"Federal and state anti-kickback statutes prohibit the exchange of anything of value in an effort to induce the referral of federal health care program business," Simmer said. "Violators on either end of the transaction risk not only civil and criminal penalties, but also possible exclusion from government health insurance programs."
"The most appalling thing about this case was that it violated the trust of some of the most vulnerable Americans – the elderly," Simmer said. "We hope this sends a powerful signal to those who care for our seniors. Families trust that the staff caring for their loved one put the elderly resident's interests first. We are grateful for the extraordinary work of Assistant Director Ed Crooke and Trial Attorney Brian McCabe in the Commercial Litigation Branch, Civil Division, United States Department of Justice; Rick Mountcastle, First Assistant United States Attorney in the U. S. Attorney's Office for the Western District of Virginia; and Wm. Clay Garrett, Assistant Attorney General and Chief of Civil Litigation for the Medicaid Fraud Control Unit in the Virginia Attorney General's Office."
About Simmer Law Group PLLC
Based in Washington, DC, the Simmer Law Group PLLC represents whistleblowers nationwide who have filed cases alleging fraud that financially impacted state and federal governments in the areas of health care, for-profit education and government contracting; as well as insurance plans in large scale recovery actions.
Relator's Second Amended Complaint
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SOURCE The Simmer Law Group