Massachusetts AG Reports $6.15M Settlement With CVS Over Workers’ Comp Drugs

Massachusetts Attorney General Andrea Joy Campbell’s office reports it has reached a $6.15 million settlement with CVS Pharmacy, Inc. to resolve allegations of overcharging for prescriptions for workers’ compensation patients.

Officials allege that the pharmacy failed in some instances to follow the state’s prescription pricing procedures that are in place to control costs in the workers’ compensation insurance system.

This case is part of the AG’s ongoing review of prescription pricing procedures in the workers’ compensation system. The office previously resolved similar matters concerning Express Scripts, Optum Rx, Walgreens, Stop & Shop, United Pharmacy, among others. Collectively, this effort has recovered more than $20 million.

The assurance of discontinuance with CVS was filed in Suffolk Superior Court. The AG identified alleged failures concerning prescriptions filled in Springfield, New Bedford, Boston and Worcester CVS locations.

The state’s workers’ compensation system sets limits for the cost of certain prescriptions for injured workers and requires companies to validate prices against certain regulatory benchmarks before processing their charges.

CVS did not admit to any facts, liability or wrongdoing in the settlement.

Under the terms of the AG’s settlement, CVS will work with the AG’s office to seek improvements to the Massachusetts workers compensation billing system and establish procedures to prevent overcharges.