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Judge Orders CVS Caremark to Pay $289.9 Million for Medicare Overcharges

The judge applied False Claims Act treble damages based on a whistleblower case alleging inflated Medicare Part D claims.

CVS Health logo is seen in this illustration taken, February 11, 2025. REUTERS/Dado Ruvic/Illustration/File Photo
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Overview

  • Court records show Chief Judge Mitchell Goldberg increased damages from $95 million to $285 million and added a $4.87 million civil penalty, bringing the total to about $289.9 million.
  • Post-judgment interest began accruing on the full award this week and will continue until payment is made in full.
  • The non-jury trial stemmed from claims by Sarah Behnke, a former Aetna actuary, who said Caremark misrepresented drug costs at chains including Walgreens and Rite Aid, causing inflated 2013–2014 submissions to CMS.
  • Goldberg rejected CVS Caremark’s bid to reduce penalties, writing the conduct was financially motivated and eroded CMS’s trust, while limiting liability to two years of overbilling.
  • CVS said it will appeal the ruling and is separately appealing a July judgment of about $948.8 million against its Omnicare unit; under the FCA, whistleblowers typically receive 15% to 30% of recoveries.