CVS Competition Probe
Florida AG Launches Probe Into CVS Caremark's Anti-Competitive PBM Practices
Florida Attorney General James Uthmeier launched a formal investigation into CVS Health on June 23, issuing a Civil Investigative Demand — a legal order to produce documents — targeting the company's pharmacy practices in the state, according to TC Palm. The probe focuses on whether CVS uses its dual role as both a pharmacy benefit manager and retail pharmacy chain to shut out independent competitors.
CVS operates roughly 800 locations in Florida and owns Caremark, one of the nation's largest pharmacy benefit managers (PBMs). PBMs act as middlemen between insurers and pharmacies, deciding which drugs are covered and how much pharmacies get paid. The state alleges CVS uses Caremark to steer patients toward its own stores — and squeeze smaller rivals out of business, Herald Tribune reported.
CVS Must Hand Over Thousands of Documents by July
Uthmeier held a news conference in Miami to announce the probe. He said Florida families deserve "real pharmacy choices — not a system rigged by one giant corporation that may favor its own stores and squeeze out competitors," according to Jacksonville.com. CVS has until July 28 to hand over the documents the state requested, including contracts, reimbursement data, and store expansion plans.
Florida's Agency for Health Care Administration is partnering with the AG's office on the investigation. Secretary Shevaun Harris said Floridians expect "a health care system that works for them, not against them." The probe is a civil enforcement action under Florida's antitrust and consumer protection laws, Naples News reported.
Independent Pharmacies Describe Audits, Low Pay, and Closures
Independent pharmacy owners say CVS's Caremark has been driving them to the brink. One key complaint: "gotcha audits," where PBMs claw back payments from pharmacies months after a prescription was filled. A 2025 survey found that 96.5% of independent pharmacists believe PBM reimbursement rates threaten the survival of their businesses, according to the National Community Pharmacists Association.
The numbers paint a stark picture nationally. More than 2,200 pharmacies closed in 2024 alone — about eight per day. Around 30 million Americans now live in a pharmacy desert, meaning there is fewer than one pharmacy per 10,000 residents nearby. In Florida, rural counties including Glades, Jefferson, and Liberty already meet that threshold, Tallahassee.com reported.
Federal Pressure on PBMs Paved the Way for Florida's Move
Florida's investigation did not happen in a vacuum. In January 2026, the House Judiciary Committee released a report called "When CVS Writes the Rules," using internal company documents to argue CVS actively suppressed competition from independent and hub pharmacies. Then in March 2026, the Federal Trade Commission and CVS Caremark moved toward a settlement over anticompetitive rebating practices.
Florida had also laid legal groundwork earlier. In 2023, Governor Ron DeSantis signed SB 1550, the Prescription Drug Reform Act, which banned PBMs from steering patients to affiliated pharmacies and required them to disclose their business ties. Uthmeier's investigation escalates that policy from regulatory oversight to a full state legal challenge, Herald Tribune reported.
CVS and PBM Industry Push Back Hard on the Claims
The PBM industry's trade group, the Pharmaceutical Care Management Association, rejected the state's framing. Its president David Marin said PBMs "continue to play a positive role... helping patients safely access and afford the medicines they need." The group also released a report claiming independent pharmacy numbers grew by 67 stores nationwide last year, suggesting the market is healthier than Florida officials say.
CVS argues its integrated model — combining insurance through Aetna, PBM services through Caremark, and retail stores — delivers lower out-of-pocket costs for members. Still, the Florida pharmacy market is enormous: a roughly $45 billion industry representing about 6.1% of the state's GDP. With more than 4.5 million Floridians aged 65 and older, the stakes for any major settlement or forced changes are very high, according to Naples News.
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