CVS to pay $6M in prescription settlement

CVS Pharmacy Inc. (Woonsocket, R.I.) has been ordered to pay $6.15 million to settle allegations that it overcharged for some prescriptions tied to workers’ compensation insurance in four Massachusetts cities including Worcester, reports Telegram & Gazette.

The settlement was announced earlier this week by the office of state Attorney General Andrea Campbell, with additional alleged overcharges that also occurred in Boston, Springfield and New Bedford.

Campbell said in a news release, “Ensuring that pharmacies follow procedures and do not drive up costs in our workers’ compensation system is an important priority for my office, and we will continue to advocate to keep this critical system available and accessible on behalf of workers and employers,” also mentioning that the state’s workers’ compensation system operates at its best when it is functional, transparent and affordable.

Kara Page, manager of corporate communications for CVS Health, told Supermarket News in an email statement that the company is “pleased to resolve this matter with the Massachusetts Attorney General’s Office (AGO).”

Page clarified that the agreement is not an admission of liability or wrongdoing and “we remain committed to complying with all laws and regulations applicable to our business.”

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A court filing processed Monday in Suffolk Superior Court alleges that in some circumstances CVS failed to follow Massachusetts law and regulations that help keep costs low in the state workers’ compensation insurance system. Various benchmarks must be reviewed when making pricing determinations for certain workers’ compensation insurance prescription drugs under state regulations.

The state workers’ compensation system sets limits for the cost of prescriptions for injured workers and requires companies to validate prices against certain regulatory benchmarks before processing their charges, reports Telegram & Gazette.

Under the terms of the settlement, CVS is expected to work with Campbell’s office to look for improvements to the Massachusetts workers’ compensation billing system and establish procedures to prevent overcharges from happening again.

“We agree with the AGO that it would be beneficial for the Division of Industrial Accidents (DIA) to publish clear rules applicable to all stakeholders and participants in Massachusetts’ workers’ compensation program, and look forward to discussing ways to facilitate compliance and improve existing standards for recommendation to the DIA,” Page told SN.