CVS settles for $36.5 million over Medicaid insulin fraud
CVS settled for $36.5 million after being found responsible for fraudulently overbilling Medicaid for insulin prescriptions.
8 sourcesRead sources
ag.ny.gov
To cover up their fraud, CVS falsely under-reported the amount of time that the supply of insulin would last and failed to comply with certain rules used to calculate refill dates.
As a result of CVS’s false claims, some Medicaid recipients accumulated large quantities of unused insulin, which was both wasteful and potentially dangerous as insulin can expire.
NEW YORK – New York Attorney General Letitia James joined a bipartisan coalition of 36 other attorneys general and the United States Department of Justice (DOJ) in securing $36.5 million from CVS Pharmacy, Inc. (CVS) for fraudulently overbilling Medicaid for insulin prescriptions.
Attorney General James and the coalition’s investigation found that CVS dispensed more insulin to Medicaid recipients than their prescriptions specified and refilled insulin pen prescriptions well before they were needed.
oig.hhs.gov
NEW YORK – New York Attorney General Letitia James joined a bipartisan coalition of 36 other attorneys general and the United States Department of Justice (DOJ) in securing $36.5 million from CVS Pharmacy, Inc. (CVS) for fraudulently overbilling Medicaid for insulin prescriptions.
portal.ct.gov
As part of the settlement, CVS also admitted and accepted responsibility for certain conduct, including that GHPs paid CVS substantial amounts for insulin pen refills that were ineligible for reimbursement and CVS pharmacies dispensed more insulin pens to GHP beneficiaries than they needed.
Specifically, the settlement resolves claims that CVS improperly requested and received GHP reimbursement for premature refills, dispensed more insulin pens than patients needed according to their prescriptions, and falsely under-reported the days-of-supply of insulin that its pharmacies dispensed.
ag.hawaii.gov
Specifically, the settlement resolves claims that CVS improperly requested and received GHP reimbursement for premature refills, dispensed more insulin pens than patients needed according to their prescriptions, and falsely under-reported the days-of-supply of insulin that its pharmacies dispensed.
As part of the settlement, CVS also admitted and accepted responsibility for certain conduct, including that GHPs paid CVS substantial amounts for insulin pen refills that were ineligible for reimbursement and CVS
T he settlement resolves allegations that, from 2010 through 2020, CVS violated the False Claims Act in connection with its billing and dispensing of insulin pens to patients enrolled in government healthcare programs (GHPs), including Medicare, Medicaid, TRICARE and the Federal Employees Health Benefits Program.
GOVERNOR KE KIAʻĀINA DEPARTMENT OF THE ATTORNEY GENERAL KA ʻOIHANA O KA LOIO KUHINA ANNE LOPEZ ATTORNEY GENERAL LOIO KUHINA HAWAIʻI MEDICAID FRAUD CONTROL UNIT RECOVERS MORE THAN $617,000 IN CVS FALSE CLAIMS SETTLEMENT N ews Release 2026-41 F OR IMMEDIATE RELEASE July 2, 2026 HO NOLULU – Attorney General Anne Lopez today announced that Hawai’i has joined the United States, District of Columbia, and 35 other states in a coordinated settlement with CVS Pharmacy, Inc., resolving allegations that the company knowingly submitted or caused to be submitted false claims to the Medicaid program related to the dispensing of insulin pens.
dailygazette.com
Under the settlement, CVS has agreed to pay $24.4 million to the United States, with an additional $12 million going to states.
newsday.com
CVS Pharmacy, Inc. will pay $2.25 million to New York after allegations that it overbilled Medicaid for insulin prescriptions between 2010 and 2020.
CVS to pay out millions to NY, federal government for alleged Medicaid fraud - Newsday
njoag.gov
This allowed CVS to overbill Medicaid for millions of dollars for more insulin than it should have been dispensing.
To cover up its fraud, CVS falsely underreported the amount of time that the supply of insulin would last and failed to comply with certain rules used to calculate refill dates.
As a result of CVS’s false claims, some Medicaid recipients accumulated large quantities of unused insulin, which was both wasteful and potentially dangerous as insulin can expire.
Attorney General Davenport and the coalition’s investigation found that CVS dispensed more insulin to Medicaid recipients than their prescriptions specified and refilled insulin pen prescriptions well before they were needed.
wtnh.com
(WTNH) — Connecticut Attorney General William Tong announced a $36.5 million settlement Monday with CVS Pharmacy in connection with claims that the pharmacy fraudulently overbilled Medicaid for insulin prescriptions over a decade-long period.