The Office of the Attorney General in Oklahoma has filed a lawsuit against CVS Caremark, alleging multiple violations related to pharmacy benefit management (PBM). This case will be the first heard in the newly established PBM Administrative Court.
Attorney General Gentner Drummond's complaint highlights 200 prescription claims that were reimbursed below acquisition cost to 15 pharmacies across Oklahoma. According to state law, this practice is not permitted. "Collectively, these pharmacies lost thousands of dollars to fill these prescriptions and help patients get the medications they needed," Drummond stated. He emphasized the importance of maintaining a fair marketplace for pharmaceuticals in Oklahoma and expressed his commitment to holding pharmacy benefit managers accountable.
Among the affected pharmacies, Broken Arrow Family Drug filled nearly half of the under-cost prescriptions. Other impacted pharmacies include United Discount Pharmacy, Thompson’s Pharmacy, and Medic Pharmacy at Hefner Pointe. These pharmacies appealed their reimbursements, but CVS Caremark denied them, citing an incorrect claim that a lower acquisition price was available.
Drummond also mentioned that there might be additional unreported violations and urged both pharmacies and patients to report any suspected PBM violations to his office.
The responsibility for PBM compliance and enforcement in Oklahoma was transferred to the Attorney General's office in November 2023.