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CVS Caremark must pay AIDS Healthcare Foundation $23 million for Part D drug reimbursement that the PBM clawed back from AHF unfairly, a court says.

Court Upholds $23 Million Judgement Against CVS Caremark for Unfair Pharmacy Reimbursement

A federal district court in Arizona has upheld a $23 million arbitration award to the AIDS Healthcare Foundation (AHF) against pharmacy benefits manager (PBM) CVS Caremark for unfair drug reimbursement.

In its November 2019 lawsuit, AHF alleged that CVS Caremark “clawbacks” of reimbursement for Part D prescription claims and its subsequent distribution of these funds to Part D plan sponsors was occurring in violation of “the covenant of good faith and fair dealing” contained in contracts between the two parties. An arbitrator agreed with this claim, ruling in favor of AHF in November 2021 and ordering CVS Caremark to pay $23 million in damages and expenses. CVS Caremark then appealed the arbitration ruling. The federal district court upheld the ruling on Sept. 15.

A federal district court in Arizona has upheld a $23 million arbitration award to the AIDS Healthcare Foundation (AHF) against pharmacy benefits manager (PBM) CVS Caremark for unfair drug reimbursement.

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