More than $2.1 million is headed to Oklahoma pharmacies after state officials announced plans to distribute fines collected from a settlement with CVS Caremark. Oklahoma Attorney General Gentner Drummond and Insurance Commissioner Glen Mulready announced in a joint statement that the money will go out to more than 900 eligible pharmacies across the state, the latest chapter in a yearslong dispute over how the pharmacy benefit manager treated independent drugstores.
The payout traces back to a settlement the Oklahoma Insurance Department reached with CVS Caremark in January 2022, according to News 9. That agreement resolved allegations that CVS Caremark had improperly assessed transaction fees against pharmacies in violation of state law. As News On 6 reported, restitution tied to those fees has already been paid out to affected pharmacies, meaning the newly distributed $2.1 million represents fines secured through the settlement rather than a repeat payment for the same fees.
Officials Frame It as a Win for Independent Pharmacies
Mulready said protecting Oklahoma pharmacies has been a shared goal for his office and the attorney general's. He also credited the attorney general and his team for helping push the matter to completion, according to the same report. The collaboration between the two offices, officials said, ensures that the insurance department's enforcement work translates into tangible relief for pharmacies statewide.
This is not the first time CVS Caremark has had to answer to Oklahoma regulators over how it treats the pharmacies that fill prescriptions for its members. The current distribution marks the third settlement involving the company, and combined, those settlements have returned more than $7 million to Oklahoma pharmacies, per the same account.
A Separate $5 Million Settlement Over Underpayments
More than ten months before this latest payout was announced, Oklahoma's attorney general revealed a separate settlement with CVS Caremark worth more than $5 million. That December 2025 agreement, reported by the Journal Record, addressed allegations that the pharmacy benefit manager underpaid pharmacies for dispensing prescription drugs — specifically, that it paid Oklahoma pharmacies less than what the medications actually cost, according to KSWO.
Of that $5 million, $125,000 was earmarked for legal costs and fees, with the remainder set aside for pharmacies that filed claims, the Journal Record's report noted. CVS Caremark neither admitted nor denied the allegations and has maintained it did nothing wrong in connection with that settlement.
Oversight Rules Give Regulators Leverage
The repeated settlements come as Oklahoma regulators have built out a framework for policing pharmacy benefit managers more broadly. Materials from the Oklahoma Insurance Department note that each day a pharmacy benefits manager conducts business in the state without a license can be treated as a separate violation, with penalties enforceable in the same manner as civil judgments. Separately, the Oklahoma Attorney General's Office has identified practices such as failing to pay pharmacies for covered services after terminating them from a network, and using so-called spread pricing in reimbursements, among the issues its compliance division monitors.
For now, the focus in Oklahoma City is on getting the $2.1 million into the hands of the more than 900 pharmacies deemed eligible, with the attorney general's office overseeing that distribution. Between the transaction-fee settlement and the more recent underpayment case, state officials have now pointed to three separate agreements with CVS Caremark as evidence that their oversight is paying off for pharmacies across the state.
