CVS Health's Caremark Unit Ordered to Pay Nearly $290 Million in Medicare Fraud Case

MT Newswires Live
2025/08/20

CVS Health's (CVS) Caremark unit has been ordered to pay roughly $289.9 million in a whistleblower case involving Medicare fraud claims, according to a court ruling on Tuesday.

The US District Court for the Eastern District of Pennsylvania awarded treble damages of $285 million and about $4.9 million civil penalty for submitting false drug pricing data through Medicare Part D sponsors Aetna and SilverScript in 2013 and 2014, according to the filing.

Caremark was found to have "knowingly caused" the submission of 513 false Direct and Indirect Remuneration reports, leading the Centers for Medicare and Medicaid Services to overpay about $95 million in subsidies, the filing showed.

"We are pleased that the June Behnke ruling was in our favor as to certain issues for CVS Pharmacy and CVS Health Corporation's liability, and disappointed the Court found against CVS Caremark on other issues," a Caremark spokesperson said in an emailed statement to MT Newswires Wednesday. "We plan to appeal the decision announced yesterday to the Third Circuit."

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