Coventry Health, which is moving more than $1 billion a year worth of pharmacy-benefits-management business from CVS Caremark to a rival PBM, accuses the company of wrongfully paying hundreds of thousands of dollars or more in prescription drug claims.
The Coventry Health account is one of several "big client losses" amounting to a net $4.8 billion in erased business for next year that CVS Caremark discussed with investors last week. While investors already knew about some of the lost accounts, including Coventry, there were more than expected, and CVS stock swooned on renewed concerns about the company's hybrid drug retailer-PBM business model.
In a breach-of-contract lawsuit filed against CVS Caremark in September and moved to a U.S. district in Tennessee last month, Coventry alleges that Caremark incorrectly paid numerous drug claims to Coventry members that it should have denied.
