Attorney General Ellison holds CVS accountable for submitting false Medicaid claims related to insulin pens

AG Ellison and coalition of 37 AGs and federal government allege CVS deliberately overbilled government healthcare programs for a decade when filling and refilling prescriptions for insulin pens

Recovers more than $400K for Minnesota’s Medicaid program

July 9, 2026 (SAINT PAUL) — Minnesota Attorney General Keith Ellison announced today that as part of a coalition of 37 attorneys general and the federal government, he has reached a settlement with CVS Pharmacy, Inc. that resolves allegations that the national pharmacy chain submitted false Medicaid claims related to the dispensing of insulin pens. The $36.5 million national settlement will see CVS pay over $850,000 for its conduct in Minnesota, including more than $400,000 in direct restitution to Minnesota’s Medical Assistance Program, which is Minnesota’s Medicaid program.

Attorney General Ellison and the coalition allege that from 2010 through 2020, CVS deliberately overbilled government healthcare programs in connection with its billing and dispensing of insulin pens to patients enrolled in Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program, in violation of the False Claims Act.

As part of the settlement, CVS has accepted responsibility for its conduct, which included requesting and receiving substantial reimbursement for insulin pen refills that are ineligible for such reimbursement. CVS also dispensed more insulin pens than were needed according to patient prescriptions and falsely under-reported the days of supply of insulin that its pharmacies dispensed.

“Insulin isn’t a luxury, it’s a medication people need to live, and Minnesota taxpayers generously help pay for insulin for Minnesotans who can’t afford to pay for it on their own,” Attorney General Ellison said. “This is a vital social compact that CVS deliberately broke — along with breaking federal law — when it knowingly overbilled taxpayers for insulin it dispensed. This resolution should be a warning to any corporation that defrauds Medicaid that we will hold them accountable.”

During the period covered by this settlement, some CVS pharmacies distributed amounts of insulin that exceeded common limits set by either government programs or pharmacy benefit managers. When claims for reimbursement were rejected, instead of following the process to request an override of those limits, CVS some pharmacies instead resubmitted their claims and listed the maximum amounts allowed under the beneficiary’s insurance plan, which represented amounts lower than the actual amount of insulin they dispensed.

Once CVS staff recorded insulin distribution amounts that were lower than the actual amounts dispensed, their auto-refill system would then at times calculate premature refill dates for patients, which resulted in some CVS pharmacies dispensing insulin pen refills to beneficiaries before their plan would have approved such refills for reimbursement.

A team from the National Association of Medicaid Fraud Control Units (NAMFCU), in conjunction with the United States Attorney’s Office for the Southern District of New York, led the investigation the allegations. The Medicaid Fraud Control Unit of Attorney General Ellison’s office is a member of NAMFCU.

Attorney General Ellison’s Medicaid Fraud Control Unit works to uncover, investigate, and prosecute individuals or organizations that steal from Medicaid and that exploit, neglect, or abuse vulnerable victims. The Medicaid Fraud Control Unit receives 75% of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,078,704 for Federal fiscal year (FY) 2026. The remaining 25%, totaling $1,692,898 for FY 2026, is funded by the State of Minnesota.