The world of pharmacy benefit management is full of confusing contracts that force employers and HR managers to work with specialized benefits consultants to navigate the contracting process. Complex language and fee structures make pharmacy benefit managers tricky to deal with—and the results can often be hazardous to an employers' bottom line.

But a recent scandal at the multi-billion-dollar chain pharmacy and PBM CVS Caremark doesn't require an expert to diagnose the problem. Recent reports from the Los Angeles Times focused on CVS Caremark's use of "automatic refill," which led to widespread anger and government investigations to determine whether the company pressured pharmacists to enroll customers in a program to automatically refill prescription drugs without customers' permission.

By auto-refilling prescriptions for customers without their consent, CVS Caremark is taking advantage of the complex system PBMs routinely abuse to increase profits. CVS Caremark's third quarter earnings released in November show significant growth, and it's hard not to wonder whether shady practices like involuntary auto-refill are a large contributor.