NASHVILLE, Tenn. (WCYB) — CVS CEO David Joyner has sent a letter to the Tennessee General Assembly, warning of closures if a bill to prohibit pharmacy benefit managers from owning pharmacies passes.

You can view the full letter below.

March 17, 2026

To the Members of the TN General Assembly,

I am writing today as the CEO and Chairman of the Board of CVS Health, a position that I have held for a little over a year. CVS Health supports over 1.5 million Tennesseans every year, in their communities, helping families struggling with an often confusing, disconnected system and the rising cost of health care. Over the last several weeks this legislature has debated how to improve health care costs, access and competition in Tennessee. I am deeply committed to working with policymakers to improve the health care system, protect access to pharmacies, and lower health care costs for the patients we see every day.

It is in that spirit that I ask you to oppose SB2040/HB1959. As it is currently written it would force the closure of our pharmacies across Tennessee, not only our home delivery and specialty operations, but also 134 community pharmacies.

These pharmacies are vital community health care anchors. Every day, our pharmacists and colleagues serve as the most accessible point of care: dispensing prescriptions, conducting health screenings, and providing medication therapy management. Our stores are open seven days a week, nights, and weekends with several stores open 24 hours. Patients already struggling with chronic conditions such as diabetes, heart disease, hypertension, and cancer may face longer travel distances, delayed refills, and increased risk of non-adherence. Research consistently shows that reduced pharmacy access correlates with poorer health outcomes, higher emergency room visits, and elevated health care costs for everyone.

We employ over 6,000 colleagues across Tennessee. Independent economic analysis finds we support 17,000 jobs; contribute $299 million in state and local taxes; we account for $2.4 billion in direct spending in the state’s economy which generates another $889 million through supply chains and induces another $942.5 million in household spending. All told we provide $4.2 billion in economic impact for the state. Our colleagues are proud to work for CVS and proud to call Tennessee home.

Throughout this process and in my meetings with legislators, the PBM is regularly a topic of conversation. I understand that many of your constituents have raised concerns about the way PBMs operate, including our own PBM. I would welcome the opportunity to discuss policy solutions that improve that system, benefitting pharmacists and patients. But this bill does not address those business practices. This legislation does not change the way a PBM operates or reimburses pharmacies.

It has been argued by some that we are making a choice, choosing one business over another. What I want to make sure you understand is the complexity of that proposition in this legislation. Caremark provides a nationwide prescription benefit to over 87 million Americans, in all 50 states. I must maintain that nationwide network to meet the commitments made in contracts with national employers and the federal government itself.

In Tennessee, as in most states, Caremark doesn’t only contract with CVS Pharmacy, but with other chains, grocers, independents, almost anywhere people can get their medication. It is simply not feasible to cease a nationwide network in one state. That leaves me with only one way to comply with this legislation, ending pharmacy operations in Tennessee.

In state after state when large chains leave the market, the reality is a small portion of their pharmacies may be acquired, but the vast majority are not, and pharmacy access is lost, and patients experience the consequences. The result will be enormous disruption to patients in Tennessee.

Our company is proud to be a part of Tennessee, a place where we continue to invest. I believe we can work together to address your concerns while also keeping our pharmacies serving their communities.

Sincerely,

J. David Joyner

—

Previous stories:

Proposed bill would limit PBMs action in Tennessee: CVS threaten closures if passed

PBM bill advances in House subcommittee, CVS ramps up opposition

Independent pharmacist speaks on FAIR Rx Act as bill is set for committee