Vogel, Slade & Goldstein Announces CVS Will Pay $36.5M to Settle Whistleblower Allegations That It Overbilled Government Healthcare Programs for Excessive Amounts of Insulin

WASHINGTON, Dec. 2, 2025 /PRNewswire/ -- The U.S. Attorney's Office for the Southern District of New York has intervened in and settled several qui tam (whistleblower) lawsuits alleging that CVS violated the False Claims Act during the period of 2010 to 2020 by dispensing and billing Government health plans for more insulin than doctors had prescribed for CVS's diabetic customers. Under the settlement, CVS will pay a total of $36.5 million to the United States, 30 States, the District of Columbia, Puerto Rico, and the Virgin Islands. The initial whistleblower case was filed by Adam Rahimi, a pharmacist who worked for CVS. The whistleblowers will receive 19.5 percent of the Government's recovery, with Rahimi receiving most of those proceeds.

Rahimi's qui tam lawsuit was filed under seal in April 2018 in the U.S. District Court for the Southern District of New York by the Washington D.C. whistleblower law firm Vogel, Slade & Goldstein. The United States filed its own complaint in the case, and the lawsuit was unsealed yesterday.

Rahimi alleged that when filling prescriptions for insulin pens, CVS often represented to patients and government payers that it was dispensing a lower "days' supply" than it was actually providing, and entered the lower days' supply in its internal computer system. Then, he alleged, because CVS's computer system often calculated the "refill date" based on the understated days' supply, CVS frequently dispensed refills of insulin long before the patient had used up the supply of insulin provided. For example, Rahimi alleged that a CVS pharmacy in Silver Spring, Maryland dispensed and charged a Medicare Part D plan for a 50-day supply of insulin pens, but recorded it as a 30-day supply. He alleged that the pharmacy then proceeded to dispense and charge Medicare Part D for seven premature refills over a span of eight months, falsely stating in each instance that it had dispensed a 30-day supply rather than the actual 50-day supply.

In a Stipulation of Settlement approved by the Court, CVS acknowledged that as a result of this practice of understating days' supply and prematurely refilling insulin prescriptions, some CVS pharmacies dispensed insulin pen refills to beneficiaries of Government health plans before the beneficiaries needed more insulin and before the payors would have approved such refills for reimbursement.

Rahimi's attorney, Rob Vogel, said: "At this critical time in our nation's history when fewer people can afford health insurance, we applaud the efforts of Adam Rahami and the lawyers at the Department of Justice and the Offices of State Attorneys General to safeguard the integrity of government healthcare programs and to hold those who overbill those programs accountable." Rahimi said: "I am grateful for the efforts of the dedicated attorneys in the U.S. Attorney's Office in New York City, who have pursued this case since 2018 and have achieved this resolution."

Media contact:  Rob Vogel – Vogel, Slade & Goldstein – 202-537-5904, [email protected]

SOURCE Vogel, Slade & Goldstein