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CVS Caremark has agreed to pay more than $5 million to settle claims by Oklahoma pharmacies that the pharmacy benefit manager (PBM) giant underpaid them for medications. The settlement is designed to reimburse pharmacies for over 68,000 prescriptions they filled between January 2024 and August 2025.
Oklahoma's Attorney General filed the suit in January 2025, seeking censure, suspension, or revocation of CVS Caremark's license, as well as fines. The settlement amount will cover the state's investigative costs and fines. Three-quarters of the fines will go to affected pharmacies, with the remaining one-fourth supporting the Attorney General's continued oversight of PBMs through its PBM Compliance and Enforcement Unit.
As part of its settlement, CVS Caremark has also agreed to various reforms, including:
- Reviewing pharmacy payment disputes against national cost estimates;
- Allowing pharmacies to use documentation of drug costs when challenging payments;
- Following state law by responding to disputes within ten calendar days; and
- Resolving additional complaints in conjunction with the Attorney General's office within 90 days
CVS Caremark has admitted no wrongdoing and stated that it settled to avoid the uncertainty and expenses related to continuing litigation.
Oklahoma's Attorney General stated that he had received more than 3,100 complaints about PBMs before filing the lawsuit against CVS Caremark. He cited an increase in the number of independent pharmacies closing due to PBM practices, leading to job losses and reduced healthcare access in rural communities.
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