CVS Health's pharmacy benefit manager unit must pay the U.S. government $95 million after a federal judge found it overcharged Medicare for prescription drugs.

The case stems from a whistleblower lawsuit filed by a former Aetna actuary who alleged CVS Caremark manipulated drug pricing to inflate Medicare claims while underpaying pharmacies.

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CVS Health plans to appeal after a judge in the Southern District of New York ordered its Omnicare unit to pay more than $948 million in penalties and damages related to invalid prescriptions.

"Medicare Advantage Whistleblower Lawsuit Alleges Insurer And Broker Misconduct", Health Affairs Forefront, June 26, 2025 . DOI: 10.1377/forefront.20250624.309189 Caption. 1101 Connecticut Ave ...

CVS unit ordered to pay $95 million in Medicare whistleblower lawsuit CVS Health's pharmacy benefit manager unit must pay the U.S. government $95 million after a federal judge found it overcharged ...

–CVS must pay the government at least $95 million after a federal court ruled in favor of a whistleblower, finding its pharmacy benefit subsidiary Caremark overcharged Medicare for generic drugs.– ...

Concerns over alleged abuses of the Medicare Advantage program have sparked several government suits and inquiries in recent ...

CVS Health and its subsidiaries have experienced a turbulent week in the courts. A former Aetna actuary in the Medicare department won a $95 million False Claims Act judgment (PDF) against ...