CVS to pay $12M settlement for allegedly overcharging MassHealth
Photo I Chris Lisinski/SHNS
Attorney General Andrea Campbell fields questions from lawmakers at a budget hearing on March 6.
Pharmacy giant CVS will pay more than $12 million to MassHealth after the attorney general alleged the company charged higher prices to the Medicaid program than to cash-paying customers in the general public.
Attorney General Andrea Campbell on Wednesday announced a settlement agreement with CVS in which the company will pay $12.25 million to the program, and implement a "yearly reconciliation process" to ensure it does not overcharge MassHealth in the future.
Campbell and her counterparts in Connecticut, Indiana and Oklahoma jointly filed a civil action in May, alleging that CVS customers who paid in cash through the ScriptSave program received discounts for years that were not offered to Medicaid recipients.
In a statement, Campbell said the settlement would "prevent future inaccurate price reporting and ensure MassHealth has the resources it needs to continue serving Massachusetts residents."
"When pharmacies overcharge MassHealth, they're undermining the integrity of our public programs and leaving taxpayers to foot the bill," she said.
A CVS spokesperson said the company agreed to the settlement "to avoid the time and expense of further litigation with Massachusetts," adding that it does not represent "an admission of liability or wrongdoing."
"The settled claims involve only Massachusetts Medicaid's unique most favored nations ('MFN') regulation," spokesperson Kara Page, said. "We'll continue vigorously defending against the claims concerning CVS Pharmacy's usual and customary [U&C] pricing brought by remaining plaintiffs in the case. For the last several years, many pharmacies, including CVS Pharmacy, have been named as defendants in other U&C lawsuits accusing the pharmacies of having submitted inflated U&C prices. In the cases involving CVS, we've prevailed many times, including by court dismissal, jury verdict, and arbitrator award."
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