Tag: PBM

Prescription pill bottle wrapped in money, representing prescription drug fraud

Centene & Pharmacy Benefit Manager Agree to Pay $215 Million to Settle Prescription Drug Fraud Scheme Allegations

On February 8, 2023, California Attorney General Rob Bonta announced that Centene Corporation agreed to pay $215 million to settle allegations that the company and its Pharmacy Benefit Manager violated the California False Claims Act by committing prescription drug fraud against Medi-Cal. Specifically, the California Department of Justice alleged that Centene submitted false reports of...
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Assortment of pills in news article at Young Law Group website. Also representing REMS

Increased Spending in Compounded Drugs Could Involve Fraud

Federal spending for compounded drugs has exploded recently and there are concerns some portion of the increase is due to fraud or overbilling, according to recent media reports. Last year, we wrote a post about the increase in Tricare fraud among compounding pharmacies. Recent data reports suggests other programs, including Medicare Part D and federal...
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Grey Concrete Building, representing Serial Whistleblower

DOJ Investigates PBMs, Market-Makers

The media has recently reported Justice Department investigations into both pharmacy-benefit managers (PBMS) and best execution of customer trades by wholesale market-making companies. PBM Investigations According to the Wall Street Journal, the Southern District of New York has requested information from Johnson & Johnson, Merck and Endo concerning their contracts with PBMs. PBMs administer drug...
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Dollar banknote on white table, representing whistleblower amendments, insider trading, and whistleblower awards.

Caremark False Claims Act Case Settles for $4.25 Million

$4.25 Million for Caremark False Claims Act Case Yesterday the U.S. Department of Justice (“DOJ”) announced an agreement with Caremark, LLC to settle allegations filed that it defrauded the federal government and five states.  Caremark, LLC is a pharmacy benefit management company (“PBM”), operated by CVS Caremark, Corp. a company which is no stranger to...
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