Berger Montague Announces that its False Claims Act Whistleblower Case Against CVS Health Will Move Forward to Trial

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PHILADELPHIA, April 4, 2024 /PRNewswire/ -- Berger Montague PC is pleased to announce that its False Claims Act whistleblower case against CVS Caremark Corp. (including its pharmacy benefit manager subsidiary, CVS Caremark) for false drug pricing to Medicare will move forward to trial. 

In a decision made public on April 2, 2024, the United States District Court for the Eastern District of Pennsylvania denied in substantial part the CVS Health defendants' motion for summary judgment and granted summary judgment to Berger Montague's client, the whistleblower, as to several elements of the whistleblower's claims. "The Court's decision represents a significant step towards combatting the lack of transparency in the PBM industry," according to David F. Sorensen, executive shareholder of Berger Montague.

The case is brought under the False Claims Act which allows private individuals to bring claims on behalf of the government to recover for fraud against the government. 

The case alleges that Caremark caused two Medicare Part D Plan Sponsors, Aetna and SilverScript, to report false and inflated drug prices for purchases made at three national chain pharmacies (Walgreens, Rite Aid, and CVS pharmacies), causing the federal government to overpay for these generic drugs.

In its summary judgment decision, the Court rejected the CVS Health defendants' attempt to have the claims dismissed without trial. Additionally, the Court granted partial summary judgment in favor of the whistleblower, ruling as a matter of law that some of the reported prices were false (leaving to the jury to decide whether additional reported prices also were false). 

"This is an important case to recover damages incurred by the government, which, as the whistleblower alleges, overpaid for drugs due to the submission of false, inflated, and fraudulent drug prices. We are very pleased with the Court's ruling and look forward to presenting our case to a jury at trial," said Sorensen. Berger Montague is litigating the case along with co-counsel Miller Shah LLP, also based in Philadelphia,

Berger Montague is one of the nation's preeminent full-spectrum complex civil litigation, class action, and mass tort law firms, with over 54 years of serving in lead roles in precedent-setting cases that have recovered more than $60 billion in damages in the fields of antitrust, securities, mass torts, civil and human rights, whistleblower cases, employment, and consumer litigation. The firm is headquartered in Philadelphia, and has offices in Chicago, Minneapolis, San Diego, San Francisco, Toronto, Washington, D.C., and Wilmington, Delaware.

Contact: David F. Sorensen, 267-979-8943, [email protected].

SOURCE Berger Montague