CVS Pharmacy Inc. Pays $18.2 Million to Resolve Alleged False Claims Act Violations

U.S. Attorney's Office, Eastern District of California

CVS Pharmacy Inc. has paid a total of $18,282,280 to the United States and the State of California to resolve allegations that the company violated the Federal False Claims Act and the California False Claims Act when it knowingly submitted claims for reimbursement for certain prescribed medications to California’s Medi-Cal program that were not supported by applicable diagnosis and documentation requirements, U.S. Attorney Eric Grant announced today.

OAKLAND — California Attorney General Rob Bonta, in collaboration with the United States Department of Justice, today announced a settlement with national pharmacy chain CVS Pharmacy, Inc. (CVS) 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 $18.2 million.

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