Aetna to court: Whistle-blower must turn over documents used to accuse CVS of $1B fraud

Aetna asked a district court to require its former chief Medicare actuary to return documents used to accuse CVS Caremark of overbilling the federal government for prescriptions since 2007, according to a recent court filing.

Here are five things to know about the case:

1. Sarah Behnke, Aetna's former chief Medicare actuary, filed a whistle-blower suit against CVS Caremark after her internal investigation found CVS Caremark allegedly inappropriately billed the government $1 billion-plus in fraudulent charges.

2. Aetna placed Ms. Behnke on administrative leave after the whistle-blower suit was unsealed in federal court in early April. The unsealing came as CVS Health, the parent company of CVS Caremark, is attempting to buy Aetna for $69 billion.

3. On June 12, Aetna filed a memorandum with the U.S. District Court for the Eastern District of Pennsylvania requesting the court order Ms. Behnke to immediately return all Aetna documents used in the case. Aetna argued Ms. Behnke took documents containing confidential, proprietary and privileged information without Aetna's authorization, including records and communications involving Aetna's in-house and outside counsel, according to the filing.

4. "They should never have been taken without Aetna's permission, or disclosed to or used by [Berger & Montague, Ms. Behnke's counsel] in the first place," Aetna claimed. "Further, the Court should preclude Berger from using, distributing, or continuing to possess any of these documents, all of which have been improperly obtained, in order to allow Aetna the opportunity to prevent the production of its privileged and protected information."

5. Aetna also asked the court to order the redaction of certain paragraphs from Ms. Behnke's complaint in which the information is used, as well as the destruction of any copies of the documents.

More articles on payer issues:
Aetna whistle-blower put on leave after accusing CVS Caremark of $1B billing scheme
Aetna whistle-blower accuses CVS of 'spread pricing' in federal lawsuit
CVS Health to acquire Aetna for $69B: 5 things to know

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