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Sept 18 (Reuters) - CVS Health Corp CVS.N:
OAK STREET HEALTH, SUBSIDIARY OF CVS HEALTH, AGREES TO PAY $60M TO RESOLVE ALLEGED FALSE CLAIMS ACT LIABILITY FOR PAYING KICKBACKS TO INSURANCE AGENT- DOJ
Source text for Eikon: https://tinyurl.com/mpvcdz75
Further company coverage: CVS.N
(Reporting By Costas Pitas and Susan Heavey)
(( sheavey@thomsonreuters.com ;))
WASHINGTON, Sept 17 (Reuters) - Pharmacy benefit manager Express Scripts has sued the U.S. Federal Trade Commission over the regulator's recent drug pricing report, asking a court to force the agency to withdraw its findings, according to court documents filed on Tuesday.
(Reporting by Susan Heavey; editing by Andrew Heavens)
(( sheavey@thomsonreuters.com ; +1-202-898-8300; ))
Keywords: HEALTH-USA/PHARMACY-ANTITRUST (URGENT)
NEW YORK, Sept. 16, 2024 (GLOBE NEWSWIRE) -- Bragar Eagel & Squire, P.C., a nationally recognized shareholder rights law firm, is investigating potential claims against CVS Health Corporation (NYSE: CVS) on behalf of long-term stockholders following a class action complaint that was filed against CVS on July 12, 2024 with a Class Period from May 3, 2023 to April 30, 2024. Our investigation concerns whether the board of directors of CVS have breached their fiduciary duties to the company.
CVS is a healthcare company that operates through three primary segments: Health Care Benefits, Health Services, and Pharmacy & Consumer Wellness. The Health Care Benefits segment purportedly offers “a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, [prescription drug plans] and Medicaid health care management services.” The Health Care Benefits segment’s revenues consist almost entirely of insurance premiums paid by customers.
The pricing and other terms of the Company’s private health insurance plans are typically determined in advance of a plan’s policy period, which is typically one year. CVS determines premiums for these plans based on internal forecasts that consider historical data and the profitability of which are dependent on the Company’s ability to accurately model, among other things, medical cost trends and health care utilization patterns. Generally, a fixed premium rate is determined at the beginning of the policy period. To the extent that unmodeled-for increases in the costs of health care and other benefits arise during a given policy period, CVS is ultimately responsible for the payment of those costs. Accordingly, the profitability of the Health Care Benefits segment is particularly sensitive to the accuracy of its cost forecasts.
The Complaint alleges that, throughout the Class Period, Defendants made materially false and misleading statements regarding the Company’s business, operations, and compliance policies. Specifically, Defendants made false and/or misleading statements and/or failed to disclose that: (i) the forecasts CVS used to determine plan premiums were ineffective at accounting for medical cost trends and health care utilization patterns; (ii) as a result, CVS was likely to incur significant expenses to cover cost increases that were not accounted for in the Company’s forecasts and thus not covered by plan premiums; (iii) accordingly, CVS had overstated the profitability of its Health Care Benefits segment; (iv) contrary to Defendants’ assurances, the revenues generated from the Company’s other primary segments were insufficient to offset the negative financial impact of the increasing expenditures within the Health Care Benefits segment; and (v) as a result, the Company’s public statements were materially false and misleading at all relevant times.
On August 2, 2023, CVS issued a press release announcing the Company’s results for the quarter ended June 30, 2023, which revealed that the Company was revising its diluted earnings-per-share (“EPS”) guidance range to $6.53 to $6.75 from $6.90 to $7.12. In a Quarterly Report filed on Form 10-Q the United States Securities and Exchange Commission (“SEC”) that same day, CVS stated that operating income, which has a direct impact on EPS, “decreased $1.4 billion, or 30.7%, in the three months ended June 30, 2023 compared to the prior year primarily due to declines in the Health Care Benefits segment[.]”
On this news, CVS’s stock price fell $2.04 per share, or 2.73%, to close at $72.32 per share on August 3, 2023.
Then, on November 1, 2023, CVS issued a press release announcing the Company’s results for the quarter ended September 30, 2023, which revealed that the Company was again reducing its diluted EPS guidance range to $6.37 to $6.61 from $6.53 to $6.75. In a Quarterly Report filed on Form 10-Q with the SEC that same day, CVS stated that while operating income increased “in the nine months ended September 30, 2023 compared to the prior year [. . .] [t]hese increases in operating income were partially offset by declines in the Health Care Benefits segment.”
Then, on February 7, 2024, CVS issued a press release announcing the Company’s results for the year ended December 31, 2023 which revealed that the Company was revising its diluted EPS guidance range to at least $7.06 from at least $7.26, its adjusted EPS guidance range to at least $8.30 from at least $8.50, and its cash flow from operations guidance to at least $12.0 billion from at least $12.5 billion. In an Annual Report filed on Form 10-K with the SEC that same day reporting the Company’s financial and operational results for the year ended December 31, 2023, CVS stated that, while operating income increased in 2023 compared to 2022, “[t]hese increases in operating income were partially offset by declines in the Health Care Benefits segment.” Moreover, in a conference call held with investors and analysts that same day to discuss the Company’s 2023 results, CVS’s Chief Financial Officer Defendant Thomas F. Cowhey stated, in relevant part, “we now expect adjusted operating income for the Healthcare Benefit segment to be at least $5.4 billion, a decrease of $370 million from our prior estimates.”
On this news, CVS’s stock price fell $0.96 per share, or 1.27%, to close at $74.36 per share on February 8, 2024.
Finally, on May 1, 2024, CVS issued a press release reporting its results for the quarter ended March 31, 2024 and revising its full-year 2024 guidance. Among other items, CVS reported $88.4 billion in revenue, missing expectations of $89 billion. The Company stated that higher utilization of healthcare services, meaning more insurance dollars spent, weighed on its results in addition to Medicare reimbursement rate cuts that will continue to pressure CVS for the remainder of the year. Accordingly, CVS issued revised full-year 2024 guidance, including “[r]evised GAAP diluted EPS guidance to at least $5.64 from at least $7.06”; “[r]evised Adjusted EPS guidance to at least $7.00 from at least $8.30”; and “[r]evised cash flow from operations guidance to at least $10.5 billion from at least $12.0 billion”. Further, in a Quarterly Report filed on Form 10-Q with the SEC that same day, CVS stated that operating income decreased $1.2 billion, or 34.1% “in in the three months ended March 31, 2024, primarily due to increased Medicare utilization, the unfavorable impact of the previously disclosed decline in the Company’s 2024 Medicare Advantage star ratings and a year-over-year unfavorable impact from development of prior-years’ health care cost estimates in the Health Care Benefits segment.”
On this news, CVS’s stock price fell $11.40 per share, or 16.84%, to close at $56.31 per share on May 1, 2024.If you are a long-term stockholder of CVS, have information, would like to learn more about these claims, or have any questions concerning this announcement or your rights or interests with respect to these matters, please contact Brandon Walker or Marion Passmore by email at investigations@bespc.com, by telephone at (212) 355-4648, or by filling out this contact form. There is no cost or obligation to you.
About Bragar Eagel & Squire, P.C.:
Bragar Eagel & Squire, P.C. is a nationally recognized law firm with offices in New York and California. The firm represents individual and institutional investors in commercial, securities, derivative, and other complex litigation in state and federal courts across the country. For more information about the firm, please visit www.bespc.com. Attorney advertising. Prior results do not guarantee similar outcomes.
Contact Information:
Bragar Eagel & Squire, P.C.Brandon Walker, Esq.Marion Passmore, Esq.(212) 355-4648investigations@bespc.comwww.bespc.com
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