Florida Attorney General James Uthmeier on Tuesday put CVS and its pharmacy-benefit manager Caremark on notice, announcing subpoenas as part of a statewide probe into whether the company’s contracts and audit practices are keeping prescription prices murky. He zeroed in on what his office called “gotcha audits” and one-sided contract terms that critics say squeeze independent pharmacies and hike costs for patients. With this move, Florida joins a growing group of states taking a harder look at pharmacy-benefit managers, whose tactics have drawn criticism from federal regulators and members of Congress.
Uthmeier detailed the new investigation at a press conference, accusing CVS, through Caremark, of “controlling market power” and confirming that subpoenas are going out for documents and testimony. FOX 35 Orlando posted the full video of the event. The attorney general’s office said it plans to review reports from pharmacists and pharmacy owners who have complained about sudden clawbacks, aggressive audits, and contractual penalties that can arrive long after a prescription is filled.
What investigators are zeroing in on
Investigators say they will scrutinize contractual clauses and audit mechanisms that reviewers have described as opaque or arbitrary, including provisions that allow unilateral changes or steep retroactive chargebacks. That focus tracks with recent federal findings. Interim staff reports from the Federal Trade Commission have flagged similar practices by major PBMs and warned that vertical integration can disadvantage independent pharmacies, as documented by the FTC.
Why states are stepping in
Across the country, state attorneys general have been using subpoenas and civil investigative demands to pry open the black box of pricing and contract terms as patients report surprise costs at the pharmacy counter. Uthmeier has followed a similar playbook before. His office previously issued subpoenas to hospital systems as part of a price-transparency push, signaling a pattern of using civil investigations to test whether large players are complying with state law. According to Health News Florida, those hospital subpoenas were part of a broader effort to force clearer pricing disclosures.
How the legal process could play out
Subpoenas and Civil Investigative Demands are investigative tools, not criminal charges, and they typically require companies to turn over documents, emails, and witness testimony. Companies usually respond through their lawyers, sometimes negotiating the scope or asking a court to narrow what must be produced. These kinds of probes can end in settlements, administrative actions, or referrals for further litigation. The attorney general’s office has relied on CIDs and subpoenas in prior investigations, according to MyFloridaLegal.
What it means for local pharmacies and patients
Independent pharmacists say that audits and punitive contract terms can make it financially unrealistic to keep their doors open, especially when reimbursement cuts and clawbacks hit months after a prescription is dispensed. Coverage of alleged PBM tactics, including a report that details antitrust shenanigans and complaints of bullying independent pharmacies, has highlighted concerns that PBMs steer business to affiliated pharmacies while keeping rebate and pricing details under wraps. For Florida patients, the outcome of this probe could eventually affect how health plans disclose drug costs or how pharmacies are reimbursed, although any reforms are likely months away as state lawyers sift through records and potential court fights unfold.
