CVS to pay $6 million to settle prescription overcharges in Mass. including Worcester

WORCESTER — CVS Pharmacy Inc. will pay $6.15 million to settle allegations that it overcharged for some prescriptions tied to workers' compensation insurance in four Massachusetts cities including Worcester.

The settlement was announced Monday by the office of state Attorney General Andrea Campbell.

Alleged overcharges also occurred in Boston, Springfield and New Bedford.

“The state’s workers’ compensation system operates at its best when it is functional, transparent and affordable,” said Campbell in a news release. “Ensuring that pharmacies follow procedures and do not drive up costs in our workers’ compensation system is an important priority for my office, and we will continue to advocate to keep this critical system available and accessible on behalf of workers and employers.”

CVS said in a prepared statement that the settlement is not an admission of guilt.

"We are pleased to resolve this matter with the Massachusetts Attorney General’s Office. The agreement is not an admission of liability or wrongdoing and we remain committed to complying with all laws and regulations applicable to our business."

Filed Monday in Suffolk Superior Court, the assurance of discontinuance alleges that in some circumstances CVS failed to follow Massachusetts law and regulations that help keep costs low in the state workers' compensation insurance system.

Under state regulations, various benchmarks must be reviewed when making pricing determinations for certain workers’ compensation insurance prescription drug charges.

The state workers' compensation system sets limits for the cost of prescriptions for injured workers and requires companies to validate prices against certain regulatory benchmarks before processing their charges.

Under the terms of the settlement, CVS will work with Campbell's office to seek improvements to the Massachusetts workers' compensation billing system and establish procedures to prevent overcharges.

CVS drove home that point in its statement.

"We agree ... that it would be beneficial for the Division of Industrial Accidents to publish clear rules applicable to all stakeholders and participants in Massachusetts’ workers compensation program, and look forward to discussing ways to facilitate compliance and improve existing standards for recommendation to the DIA."

The settlement is part of Campbell's review of prescription pricing procedures in the workers’ compensation system. Campbell's office previously resolved matters concerning Express Scripts, Optum Rx, Walgreens, Stop & Shop and United Pharmacy. More than $20 million has been recovered relating to workers' compensation drug pricing procedure violations, the news release said.

Contact Henry Schwan at henry.schwan@telegram.com. Follow him on Twitter @henrytelegram

This article originally appeared on Telegram & Gazette: CVS agrees to $6 million fine in Mass. workers' comp overcharge case