Attorney General Gentner Drummond has filed a complaint in intervention to recover any Oklahoma taxpayer funds that CVS Pharmacy fraudulently obtained as Medicaid reimbursements.
The complaint alleges the pharmacy violated the state’s False Claims Act by charging Medicaid programs higher prices than the “usual and customary” prices charged to the general public. The complaint, which was also joined by Indiana, Connecticut and Massachusetts, was unsealed this week after its filing on April 14.
“Oklahoma taxpayers deserve to see that their money is spent fairly and appropriately,” Drummond said. “I am committed to fighting corruption and will work to hold accountable anyone who tries to harm Oklahomans.”
The Oklahoma Medicaid program, called SoonerCare, is a jointly funded and administered federal and state program that covers medical costs – including prescription drug costs – for Oklahomans with limited income. SoonerCare reimburses CVS pharmacies for dispensing prescription drugs using the lowest of four reporting price points, one of which is the pharmacy’s “usual and customary price” for the public.
Oklahoma alleges that, from 2016 until at least 2022, CVS knowingly concealed lower prices offered to the public and misrepresented its usual and customary prescription drug prices to fraudulently increase Medicaid reimbursements.
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