Overview
- Prosecutors said that from 2010 to 2020 CVS pharmacies refilled insulin too early, dispensed excess quantities, and understated days-of-supply to avoid claim denials.
- The settlement totals $37.76 million, including $24.4 million to the federal government and the remainder to participating states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
- CVS admitted conduct described in the complaint, including receiving government payments for refills that should not have been reimbursed.
- The DOJ said CVS instructed staff to report plan-maximum days-of-supply for full insulin cartons, enabling premature auto-refills and leaving some patients with surplus insulin at risk of expiring.
- Officials said internal audits and PBM chargebacks flagged over-dispensing for years without correction, while CVS called insulin pen billing complex and said the settlement avoids further litigation.