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State issues $1.5M fine to pharmacy benefit manager Caremark

July 10, 2018

FRANKFORT, Ky. (AP) — The Kentucky Department of Insurance has issued a $1.5 million civil penalty against pharmacy benefit manager CaremarkPCS for violations related to reimbursements to pharmacists.

The state agency also placed the provider’s license on probation for one year.

An order from the insurance department cites 454 violations related to reimbursement claim denials that were issued to Kentucky pharmacists, and 38 more violations where Caremark provided “inaccurate or inconsistent” information.

A news release says the department’s review of the 454 claims found discrepancies between Caremark’s pricing statements made to pharmacists and information provided to the Department of Insurance from the company.

CaremarkPCS Health, a subsidiary of CVS Caremark, is one of two CVS Caremark subsidiaries licensed to operate as a pharmacy benefit manager in Kentucky.

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