CVS Health Plan Dispute

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HIV, CVS and Gilead

CVS Health denies coverage for breakthrough HIV drug, committing 'clear violation' of ACA

CVS Health will not cover Gilead's Yeztugo, generic name lenacapavir (LEN), citing "clinical, financial, and regulatory factors."

Benzinga · 1d

CVS Health Declines To Add Gilead's Steeply Priced New HIV Prevention Drug To Its Plans

CVS rejected coverage of Gilead's new HIV prevention drug Yeztugo, citing regulatory and financial factors, while facing nearly $290 million in Medicare overcharge penalties.

Stocktwits on MSN · 2d

CVS Health Reportedly Keeps Gilead’s New HIV Preventative Shot Off Its Plans, Faces $290M Medicare Fraud Ruling

CVS Health, which operates the largest U.S. pharmacy benefit manager, will not add Gilead Sciences’ new HIV prevention drug Yeztugo to its commercial or Affordable Care Act (ACA) plans for now. The decision was based on clinical,

BenefitsPRO2d

CVS Health's Caremark, other PBMs face $1.7M in fines in West Virginia

Regulators have also imposed $160,000 in fines on Cigna's Express Scripts unit; $66,000 in fines on Rightway PBM Services; ...

TipRanks on MSN2d

CVS Health (CVS) Ordered to Pay Nearly $290M for Medicare Fraud

Notably, the case came from a whistleblower lawsuit filed by Sarah Behnke, a former Medicare Part D actuary at Aetna, who ...

Forbes3mon

CVS Plans To Exit Obamacare In 2026, Affecting 1 Million Aetna ... - Forbes

CVS Health plans to exit the individual health insurance business also known as Obamacare next year, leaving approximately 1 million Aetna members in 17 states looking for new coverage in 2026 ...

Yahoo2mon

NC State Health Plan dispute with CVS Caremark may lead to ... - Yahoo

CVS Caremark identified GLP-1 drugs and Humira as points of contention, but the State Health Plan says that mischaracterizes the issues.

The Herald-Sun2mon

NC Health Plan dispute with CVS could lead to lawsuits | Durham Herald Sun

State Health Plan claims CVS Caremark withheld $31.9 million in 2023–2024 rebates. Dispute over rebate payments could raise member premiums by up to $500 annually. Contract impasse may lead to ...

Becker's Hospital Review22d

CVS’ healthcare business sees continued pressure; CEO focused on ...

CVS’ healthcare business sees continued pressure; CEO focused on ‘margin recovery plan’ Advertisement By: Alan Condon Friday, August 1st, 2025 ...

Crain's Chicago Business3mon

CVS' drug middleman gives Illinois $45M to settle rebate dispute

CVS Health subsidiary CVS Caremark, Cigna's Express Scripts and UnitedHealth Group's OptumRx collectively hold 70% of the PBM market, according to the American Medical Association. And attorneys ...

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