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Wednesday, October 23, 2019

Feds, states settle whistleblower suit with CVS

By Bryan Cohen | Apr 19, 2011


BOSTON (Legal Newsline) - Massachusetts Attorney General Martha Coakley announced on Tuesday that CVS Pharmacy has agreed to pay $9 million to 10 states as part of a settlement.

The settlement follows a whistleblower lawsuit filed in federal court in Wisconsin on behalf of the United States, Massachusetts and nine other states.

The lawsuit alleged that CVS failed to follow MassHealth's pharmacy "third party liability" regulations, which require that pharmacies, for any MassHealth recipients who also have an insurance plan that provides prescription drug coverage, must bill MassHealth no more than the amount the recipient would have been required to pay had the insurance claims only been submitted to the third-party insurer.

"The Massachusetts Medicaid Program provides critical health care services to thousands of Massachusetts residents," Coakley said. "Our office is focused on rooting out waste and abuse and recovering money on behalf of taxpayers to ensure that companies are not overcharging the commonwealth for prescription drug costs."

In addition, the settlement agreement requires CVS to comply with an amended corporate integrity agreement with the Office of the Inspector General of the United States Department of Health and Human Services, which is intended to prevent recurrence of its conduct.

Coakley's office has recovered over $205.2 million behalf of the commonwealth's Medicaid program since 2007.

The settlement has an overall worth of $17.5 million. The other states taking part are Alabama, California, Florida, Indiana, Michigan, Minnesota, New Hampshire, Nevada and Rhode Island

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