Walmart Leaving CVS Pharmacy Networks Over Reimbursement Dispute


Officials with CVS Health have announced that Walmart has opted to leave CVS Caremark pharmacy benefit management commercial and Managed Medicaid retail pharmacy networks.

This article was originally published on Pharmacy Times.

Officials with CVS Health have announced that Walmart has opted to leave the CVS Caremark pharmacy benefit management (PBM) commercial and Managed Medicaid retail pharmacy networks due to a disagreement over reimbursement increases. According to a prepared statement on the CVS website,

"Walmart requested reimbursement increases that would ultimately result in higher costs for clients and consumers."

CVS Caremark has requested that Walmart continue to fill prescriptions as an in network participating pharmacy through April 30, 2019. This transition does not impact Walmart's participation in the CVS Caremark Medicare Part D pharmacy network. In addition, Walmart's Sam's Club division remains in the CVS Caremark pharmacy networks. Walmart's termination from the CVS Caremark commercial and Managed Medicaid retail pharmacy networks is not expected to have a material impact on the financial results of the Company in 2019.

In the statement, CVS officials noted that the company's "focus now is an orderly transition for any impacted plan members and ensuring we place patient care as our highest priority." Members affected by this network change will be notified and will have access to information to help them identify nearby in-network pharmacies where they can fill their prescriptions, including independently-owned, community-based pharmacies, other local pharmacies in grocery stores and mass merchants, as well as regional and national chains.

Currently, less than 5% of affected CVS Caremark members use Walmart exclusively to fill their prescriptions.

"As CVS Caremark begins to prepare clients and members for a transition," said Derica Rice, President, CVS Caremark. "We are hopeful that Walmart will agree to work amicably with us in the best interest of patients. CVS Caremark's priority is to ensure that patients continue to have access to their medications during this transition period. We also remain open to continuing timely good faith negotiations with Walmart in the hopes of reaching an agreement to provide quality pharmacy care at a reasonable cost."

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