California AG, DOJ secure $18.2M settlement with CVS over false claims

California Attorney General Rob Bonta, in collaboration with the United States Department of Justice, announced a settlement with national pharmacy chain CVS Pharmacy over its alleged violations of the California False Claims Act. The settlement resolves allegations that between 2010 and 2021, CVS submitted pharmacy claims to Medi-Cal using false electronic certifications that certified that patients had medical conditions qualifying for the payment of pharmaceutical drugs under Medi-Cal. CVS knowingly failed to verify or document mandatory compliance for a large number of claims, resulting in the payment of millions of dollars of false claims by Medi-Cal. The settlement agreement requires CVS to pay $18.2M. “Today’s settlement holds CVS accountable for its fraudulent drug dispensing and billing practices,” said Attorney General Bonta. “Pharmacies have an important responsibility to ensure all claims they submit to Medi-Cal are verified, true, accurate, and well documented. These practices ensure safe and cost-effective prescription drug use and are essential in ensuring Medi-Cal funds go to people who actually need them. My office is committed to protecting the integrity of the Medi-Cal program and recovering ill-gotten funds.”