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National News See other National News Articles Title: CVS ordered to pay $949 MILLION in Medicaid fraud case. 3.3 million false claims. Judge says they’re “getting off easy.” A federal judge in Manhattan has ordered CVS Health’s Omnicare division to pay $948.8 million in penalties and damages after a jury found the company liable for submitting over 3.3 million false claims to Medicare, Medicaid, and Tricare between 2010 and 2018. The ruling, issued July 7, stems from a whistleblower lawsuit filed by a former Omnicare pharmacist and later joined by the Department of Justice. Judge Colleen McMahon imposed a $542 million civil penalty and tripled the $135.6 million in damages awarded by the jury, as required under the False Claims Act. CVS acquired Omnicare in 2015 and was found jointly liable for $164.8 million of the total judgment, with the court noting that CVS failed to stop 30% of the false claims submitted after the acquisition. The fraudulent billing practices involved dispensing medications to elderly and disabled patients in long-term care facilities without valid prescriptions or proper documentation. Omnicare allegedly recycled expired prescriptions by assigning new numbers without physician approval, a violation of federal billing standards. CVS argued the practices were “highly technical” and permitted in some states, and emphasized that no patients were harmed or charged improperly. Nonetheless, Judge McMahon rejected the company’s constitutional challenge to the penalty, stating, “This was 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.” See also Hochul just confirmed $50 million in taxpayer funds will cover legal fees for migrants arrested by ICE The scale of the fraud is notable. Medicaid alone loses an estimated $55 billion annually to improper payments, according to the latest CMS audit. The CVS case adds nearly $1 billion to that tally, making it one of the largest pharmacy-related fraud judgments in recent history. The False Claims Act mandates a minimum penalty of $5,000 per false claim, which in this case could have exceeded $26.9 billion if applied strictly. Judge McMahon remarked that CVS is “getting off relatively easy” given the scope of the misconduct. CVS plans to appeal the ruling, maintaining that the dispensing practices ended in 2018 and were common across the industry. The company’s annual revenue reached $372.8 billion in 2024, meaning the penalty represents less than 0.3% of its top line. Still, the judgment arrives at a time when CVS is facing pressure from declining pharmacy margins and rising medical costs in its Aetna insurance unit. The outcome of the appeal could influence future enforcement actions against other pharmacy benefit managers and long-term care providers. Poster Comment: Libs of TikTok @libsoftiktok Culver City Council, CA just approved a $50K grant to nonprofits to deliver food to illegal aliens hiding from ICE raids who are too scared to leave their house Post Comment Private Reply Ignore Thread
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