Our Take
Florida is joining a growing list of state attorneys general targeting pharmacy benefit managers, but the investigation is still in early stages and no specific violations have been alleged yet.
Why it matters
PBMs control which drugs patients can access and at what price, making them a focal point in the drug-cost debate. State-level enforcement, paired with federal scrutiny, signals the political momentum is shifting away from PBM consolidation.
Do this week
Pharmacy operations leaders: audit your PBM contract terms for exclusivity clauses and clawback provisions before your state attorney general does.
Florida Opens Investigation Into CVS Pharmacy Benefit Manager Unit
Florida's attorney general has launched a probe into CVS and its pharmacy benefit manager (PBM) subsidiary, Caremark, over allegations of anticompetitive practices in drug pricing and access. The investigation is part of a broader wave of state-level scrutiny into the PBM industry, which critics say uses its market power to raise costs for consumers and pharmacies alike.
The timing reflects a shift in enforcement priorities. State attorneys general across the country are increasingly targeting PBMs as a lever to address drug-cost inflation, moving beyond federal-only oversight.
Why PBM Enforcement Matters Now
Pharmacy benefit managers sit between insurers, drugmakers, and patients. They decide which drugs are covered, at what price, and how much patients pay at the counter. This gatekeeping power, combined with vertical integration (CVS owns both a PBM and retail pharmacies), has become a political target.
Florida's action is not isolated. Multiple states have opened similar investigations, and federal lawmakers have expressed interest in PBM reform. The convergence of state and federal pressure creates regulatory risk for the largest consolidated players, particularly CVS, which combined retail pharmacy and PBM operations after acquiring Aetna.
The specific allegations have not been disclosed in the available reporting, so the scope and severity of the investigation remain unclear.
What Pharmacy Operators Should Do
If you manage pharmacy operations, PBM contracts are now a compliance risk. Review your agreements for exclusivity clauses, formulary restrictions, and clawback provisions. Document how your PBM partner affects patient access and your reimbursement rates. States moving first will set a template for federal action, so the legal landscape is hardening faster than you may expect.
Monitor state attorney general websites in your jurisdiction. Florida's move is likely to prompt copycat investigations in other states, and early transparency with regulators often reduces friction later.