News
from the fight to #SaveIndiePharmacy
New York Times’ The Middlemen series
Lawsuit says CVS crossed 'ethical and legal line' while fighting late change to pharmacy bill
A lawsuit filed Wednesday alleges CVS Health Corp. broke the law when it sent a series of text messages to Louisiana residents asking them to lobby against a bill that would have impacted its bottom line.
Parents sue over son's asthma death days after inhaler price soared without warning
Cole Schmidtknecht, 22, had insurance but couldn’t afford to refill his asthma inhaler after the cost jumped from $70 to more than $500.
Jury Awards Major Damages Against Omnicare and CVS Health
After a month-long trial, a unanimous jury has concluded that Omnicare, the largest long-term care pharmacy in the US, dispensed drugs without valid prescriptions to elderly and disabled people living in long-term care facilities, and then fraudulently billing federal programs.
Walgreens agrees to pay up to $350M for illegally filling unlawful opioid prescriptions
Walgreens has agreed to pay up to $350 million for illegally filling unlawful opioid prescriptions and submitting false claims, the U.S. Attorney's Office for the Northern District of Illinois said in a news release Monday.
“Slow Pay, Low Pay or No Pay”
Blue Cross Louisiana OK’d mastectomies and breast reconstructions for women with cancer but refused to pay a hospital’s full bills. For some claims, it paid nothing. This investigation has led to actors and advocates to bring stories like this one to life, which can be viewed here
FTC pauses lawsuit against PBMs over insulin pricing
The Federal Trade Commission (FTC) is pressing pause on its legal fight with major pharmacy benefit managers.
UnitedHealth Group Is Being Investigated by the Department of Justice
UnitedHealth Group, the largest U.S. health insurer, is once again under federal scrutiny—this time for potentially fraudulent Medicare billing practices.
FTC case against Caremark, Express Scripts, Optum Rx can move forward, judge rules
A Missouri district court judge on Tuesday said stopping the FTC’s suit against the Big Three PBMs would be “against the public’s interest.”
UnitedHealthcare fined $3.4M by insurance regulators in North Carolina
Insurance regulators in North Carolina fined UnitedHealthcare $3.4 million after a multiyear investigation alleged dozens of instances when the insurer might have let patients wrongly face excessive bills for out-of-network health care.
22 states sue to block Trump administration cuts to NIH research payments
Attorneys general seek court order to halt 15% cap on research overhead costs
Cigna sues, wants leeway to tell customers which pharmacies to use
In 2019, Minnesota passed the Minnesota Pharmacy Benefit Manager Licensure and Regulation Act. It prevents Pharmacy Benefit Managers or PBMs from requiring customers on an insurance plan to go to a pharmacy that the PBM owns, often by mail order.
Eagan’s Prime Therapeutics hit with $10.3M judgment in price-fixing case
Safety net provider alleged pharmacy benefit manager collaborated with a rival to set low payment rates to pharmacies.
PBM Prime Therapeutics to Pay $10 Million Antitrust Case Over Price-Fixing Scheme with Express Scripts, Inc.
In a recent antitrust arbitration ruling, Prime Therapeutics, a pharmacy benefit manager (PBM) owned by 19 Blue Cross and Blue Shield Plans, was found guilty of engaging in horizontal price-fixing in collaboration with Express Scripts, Inc. (ESI), a competitor owned by Cigna.
NCPA Joins Class Action Suit Against GoodRx; CVS Caremark Corp.; Express Scripts, Inc.; MedImpact Healthcare Systems, Inc.; and Navitus Health Solutions, LLC
Says the discount card company is colluding with the named PBMs to fix reimbursements
Oklahoma takes CVS Caremark to new PBM court over alleged underpayments
Oklahoma's attorney general has accused CVS's Caremark pharmacy benefit manager unit of under-reimbursing pharmacies for prescription drugs
NEWS RELEASE: OptumRx and Walgreens Sued Over the Death of Twenty-Two-Year-Old Who Couldn’t Afford His Asthma Medication
The lawsuit alleges that on January 10, 2024, Cole tried to fill his prescription for Advair Diskus, an asthma inhaler he had taken for many years, but was told that it would cost him $539 out-of-pocket because it was no longer covered by his insurance.
UnitedHealth Group ordered to pay $165 million over deceptive sales practices
UnitedHealth Group will appeal an order to pay $165 million in penalties and restitution after a judge found a business acquired by the Eden Prairie-based insurer more than five years ago used deceptive practices to sell benefits that supplement traditional health insurance in Massachusetts.
Healthcare insurance companies blamed for 'pharmacy deserts' in Minnesota
Pharmacy benefit managers are being blamed for "pharmacy deserts" being left across Minnesota as inflating drug costs squeeze out small-town pharmacies. This local news story features our friend and fellow pharmacy advocate, Deborah Keaveny, RPh of Keaveny Drug (Winsted, MN)!
‘Ghost network’ of US healthcare providers amounts to fraud, lawsuit says
Class action finds ‘staggering’ cases of people struggling to find mental health care coinciding with mental health crisis
Drugmakers including Purdue Pharma paid pharmacy benefit managers not to restrict painkiller prescriptions, a New York Times investigation found.