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CVS Pharmacy settles false Medicaid claims related to insulin pens

CVS Pharmacy, Inc.July 9, 2026Minnesota Attorney General

Penalty Amount

$36,500,000

Summary

Minnesota AG Ellison and a coalition of 37 AGs and the federal government reached a $36.5 million settlement with CVS Pharmacy, Inc. for allegedly submitting false Medicaid claims related to insulin pens from 2010-2020. CVS overbilled government healthcare programs by requesting reimbursement for ineligible refills and under-reporting days of supply.

Remedy

CVS will pay $36.5 million nationally, including over $850,000 to Minnesota, with more than $400,000 in restitution to Minnesota's Medicaid program.

Monetary Penalty

Contract Impact

In-house legal teams should review contracts with government healthcare programs, pharmacy benefit managers, and any vendor agreements related to billing and dispensing. They should ensure clauses require accurate billing, compliance with the False Claims Act, and proper record-keeping. Also, review auto-refill system contracts to prevent premature refills and ensure days of supply are accurately reported.

Contract Search Terms

False Claims ActMedicaid billinginsulin pensauto-refill systemreimbursement claimsdays of supplypharmacy benefit manageroverride processgovernment healthcare program

Laws Cited

False Claims Act
31 U.S.C. § 3729

Violation Types

Entity Details

Entity

CVS Pharmacy, Inc.

Industry

Retail

Multistate Coalition

Official Sources

Source Evidence

Entity Name
"settlement with CVS Pharmacy, Inc."
Fine Amount
"The $36.5 million national settlement"
Laws Cited
"in violation of the False Claims Act"
Violation Types
"CVS deliberately overbilled government healthcare programs"
Remedy Summary
"CVS will pay over $850,000 for its conduct in Minnesota, including more than $400,000 in direct restitution to Minnesota’s Medical Assistance Program"

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