Friday, June 9, 2023 | Back issues
Courthouse News Service Courthouse News Service

CVS Settles Fraud Claims for Overbilling Medicaid

(CN) - CVS Pharmacies will pay the government $17.5 million to resolve claims that it submitted inflated claims for prescription drugs given to Medicaid patients, the Justice Department said.

CVS pharmacist Stephani LeFlore filed a whistleblower action against her employer in 2009 under the False Claims Act. The government's investigation claimed that CVS overcharged Medicaid in cases where patients were also eligible for third-party insurance benefits.

The undisclosed agreement settles claims in Alabama, California, Florida, Indiana, Massachusetts, Michigan, Minnesota, New Hampshire, Nevada and Rhode Island. CVS will pay the U.S. $7.9 million and the states $9.5 million.

Under a corporate-integrity agreement, government inspectors will monitor CVS's billing procedures and employee training for three years, and will issue regular reports about the company's compliance.

The case was investigated by the U.S. Attorney's Office for the Western District of Wisconsin, the Department of Human Services' Office of Inspector General and the Justice Department.


Read the Top 8

Sign up for the Top 8, a roundup of the day's top stories delivered directly to your inbox Monday through Friday.