States have begun receiving payments from CVS Pharmacy’s $36.5 million settlement over allegations that the company overbilled Medicaid programs for insulin prescriptions between 2010 and 2020.
According to federal and state investigators, CVS dispensed more insulin pen cartons than prescriptions required, refilled prescriptions before patients needed them and underreported days-of-supply data to avoid pharmacy benefit manager safeguards against early refills. Investigators alleged the practices allowed CVS to obtain Medicaid reimbursements for insulin that patients did not yet need and, in some cases, resulted in patients accumulating unused insulin supplies. CVS admitted to the dispensing conduct as part of the settlement.
More than $25 million of the settlement will be distributed to Medicaid programs in 37 states and Washington, D.C. The federal government received its $24.4 million share in December, when the Justice Department announced the agreement.
In recent weeks, several attorneys general have announced their states’ shares of the settlement. New York will receive $2.25 million, according to a June 9 news release from Attorney General Letitia James. California Attorney General Rob Bonta announced the state’s recovery of over $2.7 million the same day, and New Jersey will receive $365,725, according to a June 15 news release from Attorney General Jennifer Davenport.
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