The Illinois Office of the Attorney General (OAG) reached a settlement on behalf of the Illinois Department of Central Management Services (CMS) and taxpayers of Illinois to recover $45 million from CVS Caremark in pharmacy benefit rebates.
The settlement negotiation, led by OAG in conjunction with the Illinois Governor’s Office and CMS attorneys, resolves allegations that the pharmacy benefit manager (PBM) failed to properly disclose and remit pharmaceutical rebates owed to the State under a longstanding contract.
The funds reduce the amount requested from taxpayers for payment from the Group Insurance for State employees, retirees, and their dependents. The agreement settled claims related to rebates collected between April 1, 2020, and June 30, 2024, during CVS Caremark’s administration of pharmacy benefits for state employees, retirees, and their dependents under a contract with CMS.
Illinois Attorney General Kwame Raoul says PBMs have gone from being useful administrative service providers to behemoths that control the pharmaceutical industry at the expense of patients and independent pharmacies. He reports this settlement is part of his office’s ongoing work to hold PBMs accountable to the people of Illinois, which also includes calling on Congress to take federal action to reign in PBMs. Raoul says he will continue to advocate for reforms that ensure transparency and competition in prescription pricing.
Governor JB Pritzker says PBMs are driving up healthcare costs in Illinois by extracting extra profit from patients through opaque and often predatory tactics. He says this agreement lowers taxpayer liability and reinforces the obligation of vendors to operate with transparency and accountability. Pritzker says the State of Illinois is committed to fighting for our people and will continue to pursue policies that lower healthcare costs for Illinoisans.
A representative from CVS Health gave a statement: “This matter was previously addressed and resolved last year. The state of Illinois recently renewed its contract with CVS Caremark, and we look forward to continuing to work with the state for the benefit of its employees.”