One of Oklahoma's largest pharmacy benefit managers, CVS Caremark, has been lying to its customers about whether they can get 90-day prescriptions, top lawmakers said Monday.
This latest shot across the bow comes after CVS Caremark again sent letters to its Oklahoma customers announcing they can only fill 30-day prescriptions and that the company's mail-order prescription drug service is not available in the state. Some employers who contract with CVS Caremark also have sent out misleading letters to their employees, officials said.
CVS Caremark was hit with administrative fines by the Oklahoma Department of Insurance after inaccurately telling customers that a state law passed in 2020 prohibited those long-term prescription refills. In February, Insurance Commissioner Glen Mulready said the company was supposed to send out letters explaining consumers' options for prescriptions as part of a settlement with the Insurance Department. Instead of clarifying, he said, the letters have only spread more misinformation.
The company apparently continued sending out letters with bad information, leading Mulready to file another administrative action this month that could censure, suspend, place on probation or revoke the the company's Pharmacy Benefit Manager (PBM) license in Oklahoma. A hearing is scheduled for late May.
State Rep. Marcus McEntire (center, speaking) and other lawmakers joined Oklahoma Insurance Commissioner Glen Mulready at a news conference Monday to criticize CVS Caremark's communications with Oklahoma customers.
"Let me be as direct as I know how to be to Oklahoma constituents. The state of Oklahoma did not get rid of the ability to fill 90-day prescriptions," said House Floor Leader Jon Echols, R-Oklahoma City. "Anyone that says that is not misinformed. They don't misunderstand. They are intentionally lying to you. And we're not going to stand for it."
CVS Caremark's response to the allegations was to say that it will continue to discuss the issue with the Insurance Department and looks forward to "resolving this situation with OID to avoid any interruption to patient benefits and protect Oklahomans' access to affordable prescription drugs."
One letter sent by CVS Caremark on March 20 says Oklahoma customers can only get 30-day supplies of regular medications, only at a participating in-network retail pharmacy, and that Caremark's mail service pharmacy is not available.
A pharmacy benefit manager is a third-party administrator that manages prescription drug benefits for health plans. PBMs negotiate with drug manufacturers and pharmacies to obtain discounts on drug prices, and then process claims and reimburse pharmacies for dispensed prescriptions. The bill passed in 2020 prohibits PBMs from steering customers to specific pharmacies in an attempt to prevent monopolization and unfair business practices.
Senate Floor Leader Greg McCortney, R-Ada, said the bipartisan, bicameral attempt to regulate PBMs over the past few years have left him and others at the Capitol with battle scars.
"We've been lied about year after year after year. And that's just part of what happens in this building," McCortney said at the news conference on Monday. "But when you begin to lie to the people of Oklahoma, when you start lying to senior citizens about their ability to get their medicine, about their ability to pay for their medicine, then you drag someone who tries really hard not to be in this press room down to the press room."
"These companies take from Oklahoma consumers. They increase the cost of their prescriptions all in the name of shareholder profits," said Duncan Republican Marcus McEntire, chair of the House Appropriations and Budget Subcommittee on Health. "And we knew that the regulations we passed would result in blowback from the pharmacy benefit industry. We are seeing that now, and that is why we're here. The PBM industry is attempting to create uncertainty for our own constituents."
Mulready said it's been an ongoing battle to get CVS Caremark to accurately interpret the law. When he's tried to get the company to fix their issues, he said he was told the stance on 90-day prescriptions is a technical and contractual issue with the employers who use CVS Caremark, and that it won't be fixed until next year.
"This is one of the largest companies in the world," Mulready said. "And you tell me you can't put resources towards that to get that fixed quickly for Oklahoma consumers; I find that disingenuous at best."
Aside from the Oklahoma Insurance Department's regulatory authority, Mulready said employers contracting with CVS Caremark have a role to play, too. He encouraged Oklahomans to talk with their employers about putting pressure on the company.
Reporter: Dale Denwalt
This article originally appeared on Oklahoman: Oklahoma lawmakers say CVS Caremark's lying about 90-day prescriptions