$949 Million in Fraud, But Still in Business

What would happen if your local pharmacy submitted one wrong claim? What if they accidentally billed a prescription without the right paperwork? They would be flagged, fined, maybe even shut down.

Now imagine this. CVS Health’s Omnicare unit submitted more than 3.3 million false claims to Medicare, Medicaid, and TRICARE. Not just one, not ten, but millions. Over the course of nearly ten years. And the price they paid? A $948.8 million penalty. Then they got to keep doing business like nothing happened.

This wasn’t a one-time slip. It was systemic, calculated fraud. It included recycled prescriptions, billing without documentation, and profiting off long-term care patients who often don’t have the ability to advocate for themselves.

And yet, Omnicare is still in operation. Still serving patients. Still profiting.

Meanwhile, a small-town pharmacy can lose its contract for something as minor as a paperwork delay. No appeal. No flexibility. No second chance.

This is not just an uneven playing field. It’s a rigged system.

We’ve seen it across Alabama. Independent pharmacies that serve seniors, caregivers, and entire families are being dropped from networks for technical violations. While corporate chains that commit large-scale fraud are allowed to settle with fines and keep going.

That’s not accountability. That’s selective enforcement.

Healthcare fraud is serious. It affects patients, tax dollars, and public trust. But enforcement can’t depend on the size of your legal team or your quarterly earnings.

When billion-dollar corporations treat fines like a cost of doing business, and regulators allow it, what message does that send?

It tells communities that justice is for sale.

We need better. We deserve better.

Accountability shouldn’t depend on whether you’re a chain or an independent. Oversight should be consistent. Enforcement should protect patients, not corporations. And small pharmacies should be supported, not targeted.

Local pharmacies provide care you can’t get from a hotline. They answer questions. They catch interactions. They show up for their communities in ways mail-order chains never will.

So what comes next?

We speak out. We ask lawmakers and agencies to:

• Enforce healthcare fraud laws fairly

• Provide real oversight of PBMs and corporate pharmacy chains

• Support community-based pharmacies before more are lost

Because when a billion-dollar chain commits fraud, it shouldn’t just end in a press release. It should end in change.

And when a small pharmacy gets it right every day, they should be protected, not punished.

This isn’t just about Omnicare. It’s about the integrity of our healthcare system.

We don’t need more settlements. We need a system that puts patients first.