A proposed class-action lawsuit was filed Sept. 26 against CVS Health and CVS Caremark because of allegations the PBM required pharmacies to pay fees for Medicare Part D prescriptions.
An independent pharmacy in Iowa accused CVS Caremark — which accounts for a third of the pharmacy benefit manager market — of forcing local pharmacies to pay direct and indirect remuneration fees.
The DIR fees are an "exploitation" of a loophole that allows PBMs to request money for Medicare Part D prescriptions months or years after they were filled, according to court documents. Caremark and other PBMs allegedly ask for these fees based on performance measures they determine.
"For over half a decade, CVS Caremark has imposed increasing DIR fees on independent pharmacies based on 'performance criteria' metrics, many of which make no sense for pharmacies," the lawsuit, which seeks to be a class-action case, alleges.
A CVS spokesperson told Becker's the allegations are meritless and the company plans to defend itself.