Corporate Compliance

CVS pays $17.5 million to resolve false claims allegations

Compliance Monitor, April 27, 2011

CVS Pharmacy Inc. agreed to pay the United States and 10 states $17.5 million to resolve allegations that the company inflated prescription claims to the government, according to a Department of Justice (DOJ) press release  

According to the DOJ, CVS billed more than what it was owed for prescription drugs dispensed to Medicaid beneficiaries who were also eligible for benefits under a primary third-party insurance plan. CVS submitted the claims to Medicaid programs in Alabama, California, Florida, Indiana, Massachusetts, Michigan, Minnesota, New Hampshire, Nevada, and Rhode Island.

CVS has also executed an amendment to a corporate integrity agreement (CIA) with the OIG, that was executed on March 14, 2008, in connection with a separate investigation and settlement. The amendment to the CIA, which will be in effect for three years, calls for an independent review organization to monitor CVS’ implementation of correct billing procedures and employee training/education.

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