Medicaid and Health Care & Life Sciences and Health Care & Insurance and Pharmaceutical

Feds: CVS to pay $17.5M over inflated Rx claims

April 15, 2011

The U.S. Justice Department says CVS Pharmacy Inc. has agreed to pay $17.5 million to settle allegations it overcharged Medicaid programs in 10 states, including Indiana.

The department said Friday the settlement resulted from an investigation into claims CVS collected more than it should have from Medicaid for filling prescriptions for people who have other insurance as well. Typically, pharmacies can only bill Medicaid for the amount of a patient's co-payment in those situations.

Justice credited a whistleblower, CVS pharmacist Stephani LeFlore of St. Paul, Minn., with bringing the allegations to the government's attention. LeFlore will receive nearly $2.6 million under laws rewarding whistleblowers. The federal and 10 state governments split the rest of the $17.5 million.

The states are: Alabama, California, Florida, Indiana, Massachusetts, Michigan, Minnesota, New Hampshire, Nevada and Rhode Island.

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