CVS Caremark will pay $4.8 million in Oklahoma over ERISA, Part D fees

NCPA January 21, 2022

On Thursday, the Oklahoma Insurance Department announced a $4.8 million settlement agreement with CVS Caremark regarding the collection of transaction fees from pharmacies for Medicare Part D and ERISA plan claims. The amount of the settlement includes $2.3 million for Oklahoma pharmacies and $2.5 million in penalties. OID began investigating the PBM in September 2020, over what the state believes are violations of the Patient’s Right to Pharmacy Choice Act. PCMA v. Mulready, a case that will determine whether Oklahoma law is preempted by the federal regulations governing Medicare and ERISA plans, is pending before the U.S. District Court in the Western District of Oklahoma. Distribution of restitution and penalties included in the CVS Caremark settlement is dependent upon the outcome of the PCMA v. Mulready litigation and whether or not the court finds the Patient’s Right to Pharmacy Choice Act is preempted by federal law. NCPA has supported the Mulready case, and we will provide updates when they are available.