Wednesday, January 29th 2025, 10:59 pm
Pharmacies across Oklahoma say they are losing hundreds of thousands of dollars because they say a company, CVS Caremark, is supposed to reimburse them for prescriptions and isn't holding up their end of the bargain.
Oklahoma Attorney General Gentner Drummond is now suing CVS Caremark to recover$2 million to help Oklahoma pharmacies.
What does is the lawsuit for?
Attorney General Gentner Drummond outlined 200 individual prescription claims that were reimbursed below the cost 15 Oklahoma pharmacies paid for those prescriptions, which is in violation of state law.
What law is Drummond alleging CVS Caremark violated?
The law says that the prescription benefit manager must pay us the cost of the drug or they must tell pharmacies what medication it can purchase from its current wholesaler at the price a PBM is willing to pay.
Are prescription benefit managers saying which wholesalers it will accept?
"For regulatory reasons that are a little bit difficult to explain we can't simply shop multiple wholesalers to try to get the product," said Todd Pendergraft, pharmacist.
Pendergraft says PBM's approve wholesalers pharmacies don't normally use.
What is a prescription benefit manager?
An organization that manages prescription drug benefits for clients like health insurers, employers, and Medicare Part D drug plans.
What can pharmacies do when they don't get refunded ?
They can appeal but many don't because they usually get denied. Pendergraft says he then files complaints with the Attorney General.
What impact does this have on pharmacies?
Broken Arrow Family Drug owner, Todd Pendergraft says he has to turn at least three customers away a day because of pricing issues.
Pendergraft says he's lost at least $150,000 from not getting prescriptions refunded. He also says this issue is not only affecting small pharmacies but is causing chains like Walgreens to close some stores.
Did CVS Caremark respond to this lawsuit?
News On 6 asked Caremark for an interview to talk about the lawsuit, they sent us a statement that says,
"CVS Caremark delivers value daily to our Oklahoma clients and their members. We are reviewing the allegations in the complaint and will respond to them in due course.”
Chloe Abbott joined News On 6 as a multimedia journalist in October 2023. She now serves as a reporter. Before joining the News On 6 team, she worked in Shreveport, Louisiana for two years as an anchor/MMJ for the ABC affiliate, KTBS. Chloe has covered severe weather, crime, sports, and Mardi Gras.
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