CVS Caremark ordered to reimburse $3.6 million for improper assessment of DIR fees

NCPA June 29, 2023

A federal court judge ordered CVS Caremark to comply with a 2022 arbitrator’s award directing the PBM to reimburse a San Francisco pharmacy for the improper assessment of DIR fees. Chief District Court Judge for Arizona G. Murray Snow upheld last year’s finding that Caremark failed to comply with the Any Willing Provider Law (AWPL) and pay Mission Wellness Pharmacy $3.6 million plus interest. Under AWPL, the court said, Caremark is obligated to provide "reasonable and relevant" reimbursement rates to Mission Wellness for lost revenue while participating in Caremark’s Medicare Part D networks. “This outcome not only upholds the rights of independent specialty pharmacies but also highlights the importance of fair and equitable practices within the pharmacy industry,” said a representative of Mission Wellness’ attorney, Boston-based Frier Levitt, in a recent LinkedIn post. Learn more at NCPA’s website and check out a recent episode of the Independent Rx Forum podcast about what to expect with the DIR hangover, a co-production of NCPA and Pharmacy Times.