Aug 20, 07:40 PM

Judge Orders CVS Caremark to Pay $290 Million Over Medicare Billing

A federal judge has ordered CVS Health’s pharmacy-benefit manager, Caremark, to pay $289.9 million after finding the company inflated prescription-drug costs billed to Medicare Part D in 2013 and 2014. Chief Judge Mitchell Goldberg of the U.S. District Court for the Eastern District of Pennsylvania tripled an earlier $95 million damages figure to roughly $285 million under the False Claims Act and added a $4.87 million civil penalty. The non-jury case was brought by whistleblower Sarah Behnke, a former head actuary for Medicare Part D at Aetna, who alleged Caremark caused insurers including Aetna to submit overstated cost reports to the Centers for Medicare and Medicaid Services. Goldberg said evidence showed the overbilling was “financially motivated,” undermining public trust in the program. CVS, based in Woonsocket, Rhode Island, said it will appeal. The decision follows a separate July ruling in which a Manhattan federal judge ordered CVS’s Omnicare unit to pay $948.8 million over other alleged billing irregularities.

#CVS Health #Caremark #Mitchell Goldberg #False Claims Act #Sarah Behnke #Aetna #Goldberg #CVS #Woonsocket #Rhode Island #Manhattan #Omnicare

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Judge Orders CVS Caremark to Pay $290 Million Over Medicare Billing

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