
CVS Caremark ordered to pay $290M in false claims suit
A federal judge has ordered CVS Caremark to pay nearly $290 million in damages after determining the pharmacy benefit manager overbilled Medicare for prescription drugs, according to court documents reviewed by Becker’s.
Four notes:
- In his Aug. 19 ruling, Judge Mitchell Goldberg of the U.S. District Court for the Eastern District of Pennsylvania said CVS Caremark must pay $285,000,000 in actual damages and nearly $4.9 million in civil penalties. The decision stems from claims dating back to 2010, when CVS Caremark allegedly caused health insurers, including Aetna to submit inflated reimbursement requests to the federal government.
- The case was brought forth in 2014 by Sarah Behnke, a former Aetna actuary, under the False Claims Act. CVS acquired Aetna in 2018.
- The latest ruling follows a June decision in which Mr. Goldberg ordered CVS Caremark to pay $95 million in damages. The company argued that the amount was substantial and should not be increased. However, Mr. Goldberg rejected this argument, saying evidence showed the company’s actions were financially motivated and eroded public trust.
“CMS relies on companies like Caremark to truthfully and accurately report Part D drug prices,” he wrote in the ruling. “Caremark’s conduct broke trust, and as a result, the public’s trust in CMS.”
- CVS said it disagrees with the ruling and intends to challenge it.
“We are pleased that the Behnke ruling in June was in our favor as to certain issues for CVS Pharmacy and CVS Health Corp.’s liability, and disappointed the court found against Caremark on other issues. We plan to appeal,” a CVS spokesperson said in a statement to Becker’s.
The post CVS Caremark ordered to pay $290M in false claims suit appeared first on Becker’s Hospital Review | Healthcare News & Analysis.