Whistleblowers brought the two cases alleging fraudulent overbilling.
In the first case, Goldberg tripled to $285 million the damages he had ordered CVS Caremark to pay in June, citing the federal False Claims Act. He added a $4.87 million civil fine.
“Goldberg rejected CVS' request to pay less, saying that while CVS Caremark was liable for only two years of overbilling, evidence at trial ‘made clear that the fraud was financially motivated, not the result of some innocent or mistaken belief,’” according to a report in Reuters.
Goldberg presided in March over a non-jury trial in the whistleblower case brought by Sarah Behnke, a former head actuary for Medicare Part D at Aetna.
“She accused CVS Caremark of having caused health insurers such as Aetna to submit inflated claims since 2010 to the Centers for Medicare and Medicaid Services (CMS), while pharmacies such as Rite Aid and Walgreens were paid less,” reported Reuters.
Second Blow to CVS
Goldberg's ruling was the second legal blow to CVS. Last month, a Manhattan federal judge ordered CVS' Omnicare unit to pay $948.8 million in a separate whistleblower lawsuit alleging fraudulent billing.
In the July decision, U.S. District Judge Colleen McMahon in Manhattan imposed a $542-million penalty for filing 3,342,032 false claims between 2010 and 2018. In addition, McMahon also awarded $406.8 million of damages, representing three times the $135.6 million that a jury had previously awarded.
DOJ Lawsuit Pending
CVS is also...
New York-based partner Frank A. Mazzagatti is scheduled to present at the 2025 Illinois Association of Healthcare Attorneys (IAHA) 43rd Annual Health Law Symposium on November 6, 2025, in Chicago, ...