AG Rutledge to investigate CVS Caremark reimbursement rates to pharmacists

by Talk Business & Politics staff (staff2@talkbusiness.net) 694 views 

Arkansas Attorney General Leslie Rutledge announced on Thursday (Feb. 8) that she will investigate complaints about reimbursement rates between pharmacy benefits manager, CVS Caremark, and Arkansas pharmacies.

In a statement, Rutledge said she has “demanded information” from CVS Caremark after receiving complaints of “plummeting medication reimbursement rates” paid to local pharmacies.

“The change in reimbursement rates by the Pharmacy Benefit Managers has hurt Arkansans in every community across the state,” said Rutledge. “Local pharmacists are critical members of Arkansas’s communities. Due to these changes, pharmacists are facing tough decisions because the reimbursements do not cover the actual cost of the medications. When public health is threatened, all Arkansans suffer.”

Since the first of the year, pharmacists in Arkansas have complained they are losing money on reimbursement rates for every prescription they fill for patients covered by health insurance exchange plans administered by Arkansas Blue Cross Blue Shield and Ambetter, including those in the Arkansas Works program.

CVS Caremark is the pharmacy benefits manager (PBM) for Blue Cross and Ambetter. PBMs serve as middlemen between insurance carriers and pharmacies.

Rutledge said she began reviewing reports that CVS Caremark reduced its reimbursement rate for pharmacies in the Arkansas Health Insurance Marketplace. In roughly 20% of prescription fills, prescription reimbursement rates reportedly dropped lower than purchase costs, she said.

Investigators and attorneys for the AG’s office have requested information pertinent to establishing if the reimbursement rate change triggers provisions of Arkansas’ Deceptive Trade Practices Act.

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