OKLAHOMA CITY – The state Attorney General’s Office announced a settlement of more than $5 million with CVS Caremark to resolve allegations that the Pharmacy Benefit Manager paid Oklahoma pharmacies less than what the medications actually cost.
PBMs act as middlemen between insurance companies and pharmacies, determining how much pharmacies get paid for dispensing prescription drugs.
Under the settlement, CVS Caremark will pay $5,081,520 to reimburse pharmacies for 68,099 prescriptions filled between January 2024 and August 2025 where they were paid less than what the drugs cost them.
“This settlement puts millions of dollars back into Oklahoma pharmacies so they can continue serving their communities,” Attorney General Drummond said. “We’re protecting your access to the prescriptions you need and the pharmacists you trust, especially in small towns where the local pharmacy is often the only option for healthcare.”
Deputy Attorney General Michael Leake, who oversees the PBM Compliance and Enforcement Unit, praised the Oklahoma pharmacies that came forward to report the underpayments.
“This outcome would not have been possible without independent and community pharmacies willing to document their losses and stand up for their patients,” Leake said. “Their complaints gave us the evidence we needed to secure restitution, penalties, and meaningful reforms that will protect Oklahoma patients and pharmacies.”
The Attorney General’s Office will notify each eligible pharmacy in writing and provide instructions for receiving payments under the settlement. Pharmacies that believe they were paid below cost are encouraged to file complaints with the PBM Compliance and Enforcement Unit.
The settlement also includes fines and covers the state’s investigation costs. Three-fourths of the fines will be sent directly to affected pharmacies, while 25% will support the A.G.’s continued oversight of PBMs.
In addition to monetary relief, CVS Caremark has agreed to reforms that include reviewing pharmacy payment disputes against national cost benchmarks, allowing pharmacies to use documentation of actual costs when challenging payments, responding to disputes within 10 calendar days as required by Oklahoma law, and working with the Attorney General’s Office during a 90-day period to resolve additional complaints.
CVS Caremark denies any wrongdoing and agreed to the settlement to avoid the costs and uncertainty of continued litigation.