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CVS to Pay $17.5M to Settle Medicaid Billing Case

John Commins, for HealthLeaders Media, April 19, 2011

Under the settlement, the retailer agreed to  pay the United States $7.9 million and the states $9.5 million plus interest. CVS has also amended a corporate integrity agreement with the Department of Human Services, Office of Inspector General, which has been in effect since March 14, 2008, in connection with an earlier, separate settlement.

The amendment, which will be in effect for three years, will monitor CVS's implementation of correct billing procedures and the training and education of employees. An independent auditor will issue reports on CVS's compliance.

The allegations were brought to the government by Stephani LeFlore, a CVS pharmacist in St. Paul, MN, in a whistleblower lawsuit. LeFlore will receive a total of $2.5 million as her share of the settlement.

The Justice Department said it has used the False Claims Act to recover more than $5.5 billion since January 2009 in cases involving fraud against federal healthcare programs.  


John Commins is a senior editor with HealthLeaders Media.

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1 comments on "CVS to Pay $17.5M to Settle Medicaid Billing Case"


gina (4/19/2011 at 10:49 AM)
Does this affect the customers in anyway. The actual insured? Just curious.