CVS Caremark Vows to Appeal $290 Million Ruling

August 25, 2025 – In a high-profile legal ruling, a federal judge has ordered CVS Caremark, the pharmacy benefit manager arm of CVS Health, to pay $289.9 million in total — combining damages and penalties — for inflating Medicare Part D prescription drug costs. The judgment stems from a whistleblower lawsuit filed by Sarah Behnke, a former Aetna actuary, who exposed the scheme in 2014. She alleged that CVS Caremark submitted false drug cost reports during 2013 and 2014, resulting in $95 million in Medicare overcharges.

Philadelphia federal Chief Judge Mitchell Goldberg, presiding over the case, found Caremark’s conduct reflected reckless disregard and willful ignorance, though not actual knowledge of fraud. Under the False Claims Act, he tripled the initial damages and added a civil fine of $4.87 million, ultimately bringing the total to nearly $290 million.

CVS has expressed disappointment with the ruling and plans to appeal. Interest will accrue on the judgment until full payment, benefiting both Behnke and the federal government.

This ruling marks another major legal setback for CVS, following a separate judgment earlier this year requiring its Omnicare unit to pay nearly $949 million in a different fraud case.