Florida’s top legal official has launched a sweeping investigation into healthcare giant CVS Health Corporation over concerns that the company is using its massive market footprint to unfairly manipulate the state’s prescription drug market.
Attorney General James Uthmeier issued a Civil Investigative Demand on Tuesday to CVS, which owns both the Caremark pharmacy benefit manager (PBM) and roughly 800 retail pharmacies across Florida. The state’s probe focuses on whether the corporation unfairly favors its own stores while crushing smaller, independent competitors.
“Florida families and seniors deserve access to affordable medication and real pharmacy choices—not a system rigged by one giant corporation that may favor its own stores and squeeze out competitors,” Uthmeier said. “This investigation will uncover the truth and protect fair competition for all Floridians.”
Pharmacy benefit managers, or PBMs, act as middlemen in the healthcare industry. They wield immense control over the market by deciding which medications insurance plans will cover, how much pharmacies are paid for dispensing those drugs, and where patients are allowed to fill their prescriptions. Caremark is one of the “big three” PBMs that collectively handle about 80 percent of all prescriptions filled in the United States.
Because CVS Health owns both this dominant middleman and more than 9,000 retail locations nationwide, state officials are raising flags about vertical integration and self-preferencing. The state’s investigation is specifically looking into whether CVS/Caremark actively steers patients away from local businesses toward its own locations, and whether it pays its own affiliated stores higher reimbursement rates than independent pharmacies for the exact same prescriptions.
The state is also examining CVS’s use of aggressive audits that claw back payments from independent pharmacies, alongside highly restrictive contracts. State officials note that these practices allegedly force local pharmacies to close down, creating “pharmacy deserts” that leave vulnerable families and seniors with fewer choices and higher out-of-pocket costs.
The Agency for Health Care Administration (AHCA) is backing the legal move. “Floridians expect a health care system that works for them, not against them,” said AHCA Secretary Shevaun Harris. “The Attorney General’s action is an important step toward that future, and AHCA is proud to stand alongside this effort to ensure accountability of PBMs.”
Local pharmacists are also cheering the state’s intervention, pointing to years of financial strain under current PBM practices.
“The Attorney General’s action today sends a clear and necessary message: the era of unchecked PBM abuse in Florida is over,” said Aneesh Lakhani, the incoming President of the Florida Pharmacy Association. “My patients deserve better. Florida deserves better. The system wasn’t broken, PBMs broke the system. We will not rest until they are held fully accountable.”
The legally binding demand forces CVS to hand over thousands of internal documents and provide sworn testimony covering its reimbursement rates, pharmacy contracts, auditing procedures, patient steering, drug rebates, and future expansion plans. The company faces a strict deadline to turn over the requested information by July 28, 2026.
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