CVS Health Corp. and Walgreens Boots Alliance Inc. were sued by California customers who accused the drugstore operators of charging co-payments for certain prescription drugs that exceed the cost of medicines.
CVS, the largest U.S. pharmacy chain by number of stores, overbilled consumers who used insurance to pay for some generic drugs and wrongfully hid the fact that the medicines' cash price was cheaper, Megan Schultz said in her lawsuit. Schultz said in one case she paid $166 for a generic drug that would have cost only $92 if she'd known to pay cash.
[...] In her suit, Shultz accused CVS of clawing back her co-pay because the chain was in cahoots with the pharmacy benefit managers who got the extra money. The practice was part of CVS's agreements with benefit managers, such as Express Scripts Holding Co. and CVS Caremark, according to the suit filed Monday in federal court in Rhode Island. CVS is based in that state.
"CVS, motivated by profit, deliberately entered into these contracts, dedicating itself to the secret scheme that kept customers in the dark about the true price'' of drugs they purchased, Schultz's lawyers said in the suit, which is seeking group status.
[...] The lawsuits follow at least 16 other cases around the U.S. targeting drugstore chains' alleged co-pay clawback practices. The clawback occurs when patients hand over co-payments set by a pharmacy benefit manager that exceed the actual cash cost of the drug. The benefit managers pocket the difference, according to the complaints.
Most patients never realize there's a cheaper cash price because of clauses in contracts between pharmacies and benefit managers that bar the drugstore from telling people there's a lower-cost way to pay, according to the complaints.
[...] The cases are Megan Schultz v. CVS Health Corporation, 17-cv-359, U.S. District Court for the District of Rhode Island (Providence); and David Grabstald v. Walgreens Boots Alliance Inc., 17-5789, U.S. District Court, Northern District of Illinois (Chicago).
Source: Bloomberg
Also at The Boston Globe, The Chicago Tribune, The Los Angeles Times, and NBCNews
Related Stories
CVS dives deeper into medical services, offering virtual visits through Teladoc
CVS' MinuteClinics are going virtual. The drugstore chain plans to make video visits available nationwide by the end of the year through a partnership with Teladoc Health, CVS' latest pivot away from retail and toward health-care services. CVS already offers virtual appointments, branded as MinuteClinic Video Visits, in nine states and the District of Columbia.
MinuteClinics treat people with minor illness and injuries like coughs and rashes. These walk-in locations are a way to keep customers coming into CVS' stores as more shoppers buy everyday items on Amazon. Making it possible to visit a MinuteClinic without actually walking into one may hamper that, but it could help CVS reach more people.
With virtual visits, known in the industry as telehealth or telemedicine, CVS can reach people who may not be able to visit one of its roughly 1,100 locations. MinuteClinics are a key part of CVS' $69 billion acquisition of health insurer Aetna.
Also at USA Today.
Previously: CVS Attempting $66 Billion Acquisition of Health Insurer Aetna
Related: CVS Health Is Sued Over 'Clawbacks' of Prescription Drug Co-Pays
CVS Limits Opioid Prescriptions
Telemedicine Prescriptions Could Undermine State Abortion Restrictions
(Score: 0) by Anonymous Coward on Saturday August 12 2017, @07:51PM (5 children)
I always wonder what leads up to stupid shit like this. At some point, people must have gotten together and had a conversation along the lines of "What can we do to increase our profit margin, because we can't raise prices since then people will shop elsewhere" to which someone must have said "hey, let's do this stupid thing right here. I know a guy over at place P whom I can give a call. No one will ever find out, trust me". Why is there never anyone in the room that goes "but that's wrong on so many levels, you dense motherfucker...!"
(Score: 2, Insightful) by Virindi on Saturday August 12 2017, @08:09PM
Perhaps sometimes there is. And perhaps sometimes, that person's argument wins the day. You only hear about the times it loses.
(Score: 1) by khallow on Saturday August 12 2017, @08:12PM
(Score: 3, Insightful) by Anonymous Coward on Saturday August 12 2017, @08:15PM
"It is difficult to get a man to understand something, when his salary depends on his not understanding it."
― Upton Sinclair
(Score: 2) by kaszz on Saturday August 12 2017, @10:30PM
Just look at how Google treated James Damore who dared to shed some light on another issue handled badly.
An organization that punishes all but yes-sir will enable themselves to run full speed into any wall with the only feedback being getting the skull crushed ;-)
(Score: 0) by Anonymous Coward on Sunday August 13 2017, @04:39AM
Selection bias. The guy who increases the company's bottom line gets promoted. The guy who cares about society and ethics remains mid level until he quits to try to go do something meaningful with his life.
I think capitalism is still the best we have, but it has a major problem in that income and 'value' are not well correlated. Ripping people off simultaneously maximizes income while minimizing revenue. And regulations are kind of pointless since our elections are so broken that invariably end in scenarios like we have today where the former head [wikipedia.org] of the FDA and the so called 'food czar', an Obama appointee, was a Monsanto VP and lawyer. His big trial was arguing that private companies ought be allowed to allow to add at least some, 'de minimus' amount, of carcinogens to food. No conflicts of interest with him heading the FDA, nope none at all.
A coordinated public could solve the problem pretty easily. Get 3 people in front of every CVS in the country holding up a sign giving information on how they've been intentionally ripping people off and suggesting they go to a pharmacy that doesn't engage in such practices. The mere threat of something like this happening would lave companies less happy to rip people off. But we'd all rather post on social media and bitch about things to our echo chambers, or write their social media accounts a nasty message on Facebook or Twitter or whatever - that nobody who was unare of such behavior will ever see and that they'll likely ignore (and/or delete) in any case. It's so much easier than actually going somewhere and holding up a sign, and anyhow I can convince myself writing things like this is having a positive effect by itself, or excuse myself for not personally engaging in such actions because reasons. No cognitive dissonance there, nope none at all.
(Score: 5, Insightful) by jelizondo on Saturday August 12 2017, @08:18PM (20 children)
Every time there is a story like this I wonder where are the usual Soylentils who spout the benefits of the free market and non-interference from the big ugly government?
Where are the arguments like ‘fucking idiots they deserve to pay more ‘cos they did no research’? Or ‘Well, they had it coming, why buy there? There’s plenty other places’
Why some people are thick enough not to understand that a function of democratic government (i.e. for the people by the people) is precisely to protect citizens against abuse from the stronger? And if the abuse happens, the government should punish those abusing the public.
But no, let the market fix everything, miraculously like in some religion of old…
(Score: 3, Insightful) by kurenai.tsubasa on Saturday August 12 2017, @08:29PM (9 children)
This is an easier problem for the free market to fix unlike an infrastructure problem that indicates a natural monopoly like internet connections.
Healthcare in the US is not a free market, and it hasn't been in a long time, way before the ACA (“Obamacare”). Shopping around between Walgreens, Meijer, CVS, that family-owned pharmacy on the south side of town, just to name a few in my neck of the woods, is a very easy thing to do, or at least it would be in a free market.
The pharmacy I used to be able to use online let me choose between 3–4 different manufacturers for each of my meds. Some were really cheap but didn't see too trustworthy. Others were overpriced for no reason I could discern. In all cases, the total cost was way less than with “insurance.”
But in the end, all things considered, single payer is a viable, proven model. It beats the pants off the “insurance” middleman complex in the US. For emergency care, this is a no-brainer. Perhaps for more routine care, it really is beyond the capabilities of most people to manage. We either need to go free market or single payer. Instead, the US has a system of middlemen that is bleeding us dry, the worst of both worlds and as far as I can tell with none of the good of either.
I've noticed that in the Republican hand-wringing, for what little of it I've paid attention to (they need to shit or get off the pot already), the insurance companies really love the ACA, for all of their crybaby antics when it was implemented.
(Score: 1, Interesting) by Anonymous Coward on Saturday August 12 2017, @08:46PM (8 children)
I've yet to see a country which has single-payer, universal health care revolt against it and try to repeal it.
(Score: 0, Flamebait) by jmorris on Saturday August 12 2017, @09:03PM (6 children)
Because it always comes wrapped up in a soul destroying Socialist welfare state. People become so hopeless under such a system they simply lose hope and commit suicide. Whether it is an overdose, a 9mm to the dome, state assisted suicide or simply ennui to the point the society simply doesn't reproduce and fades away, the end is the same. If they did wake up enough to see what is happening to them it would be time for the State to open up a few camps and "liquidate a few Kulaks." Socialism == Death.
Point to the exception. Ain't one.
(Score: 2, Touché) by Anonymous Coward on Saturday August 12 2017, @10:27PM
Does this mean if we ever pass single payer, we will no longer have to hear this crap from you?
(Score: 4, Insightful) by Whoever on Saturday August 12 2017, @11:01PM (1 child)
That was a fantastic example of Poe's law in action. I cannot tell if the rant was serious or tongue in cheek.
Do I mod it as Funny, or Troll? It's by jmorris which is usually an indicator that a troll mod is appropriate, but it reads so much like it could be sarcastic, that I am very confused.
(Score: 3, Funny) by Azuma Hazuki on Sunday August 13 2017, @04:03AM
Please trust me on this: J-Mo is as serious as an Ebola outbreak. No one can act that well and that consistently.
I am "that girl" your mother warned you about...
(Score: 0) by Anonymous Coward on Saturday August 12 2017, @11:27PM (1 child)
Denmark
(Score: 2) by jmorris on Saturday August 12 2017, @11:40PM
Birth rate is 1.69. Dying. Thanks for playing, loser. :)
(Score: 2) by jelizondo on Saturday August 12 2017, @11:34PM
I guess the U.S. has become socialist then since suicide rates [soylentnews.org] among white people have increased steadily since about 2004. (see graph Suicide Rates by Ethnicity on linked article.)
(Score: 2) by kaszz on Saturday August 12 2017, @10:42PM
It works provided the main beneficiaries are the tax payers or very likely tax payers ie belonging to the same cultural and ethnic setup. Such that the actual payers see they have a in-group connection to those that use the system. There always has to be an incentive to contribute, meaning everyone in the in-group gets food and housing. Any extras like caviar, boat, big screen tv etc has to be earned..
A trust capital also has to exist that the system is observed to deliver on promises and that the quality is what is perceived as adequate.
(Score: 3, Insightful) by Justin Case on Saturday August 12 2017, @08:51PM (6 children)
Our "healthcare" (actually insurance) system is ZERO PERCENT FREE MARKET and TOTAL interference from the big ugly government. That's the problem!!!
How's that working out for you so far? In case you haven't noticed, "government" === "the stronger".
(Score: 3, Insightful) by jelizondo on Saturday August 12 2017, @11:44PM (5 children)
Who is the most powerful: Themistocles or his son? The figure head or the real power behind the throne?
You see the problem is not the government, it is us, who have let the government be controlled by big money. So you are wrong, the government is not the strongest, Wall Street is.
(Score: 3, Touché) by Justin Case on Sunday August 13 2017, @12:40AM (4 children)
Who let them? I didn't. Did you? Why???
Every time I vote they pay no attention to me whatsoever.
The strong will do strong things, like control stuff. They can, so they will. They don't care about your opinion.
Trusting the government to fix anything -- while simultaneously pointing out that the government is not under our control -- is, well... naive? irrational? Let's just say, the product of a brain I don't understand.
(Score: 1, Interesting) by Anonymous Coward on Sunday August 13 2017, @01:52PM (1 child)
The greatest argument for anarchy that exists... Take responsibility for your life and your world in your own hands and refuse the usurpers!
(Score: 2) by Justin Case on Sunday August 13 2017, @02:14PM
I'm not generally an advocate for outright anarchy, but at least if one chooses to go that way, you don't need to convince 100 million other people to join you.
You just do it. To whatever extent you think you can sustain.
(Score: 2) by jelizondo on Sunday August 13 2017, @11:36PM (1 child)
Thank you for your reply. I’m sorry if it appears that I trust the government (this one or the past few), I was merely pointing out what the government function should be.
From your comment it seems that you have been voting independent, which I believe is the way to go. Both parties are too entangled with special-interests and Wall Street to let anyone be a candidate who is not properly vetted and controlled, so by the time you vote, it's always their guy .
So what do we do? What I’m doing, trying to convince one person at a time to go independent until there are so many of us that politicians can’t ignore us anymore.
(Score: 2) by Justin Case on Monday August 14 2017, @03:57PM
Thank you also. Yes I usually avoid voting for either of the major puppets. "The lesser of two evils is still evil."
If you actually get involved -- I mean really deeply involved -- with one of the smaller political movements, you will see 100 times how the big powers use every trick in the book, including dirty tricks, to shut you down. Democracy is just an illusion to keep the masses complacent by thinking they have a voice.
How to fix it? I don't know. I just know everyone calling for more central concentration of ever growing power is probably pulling us in the wrong direction.
(Score: 1, Interesting) by Anonymous Coward on Sunday August 13 2017, @05:12AM (2 children)
It has to be said, you can go to developing nations that otherwise have pretty good healthcare yet have no real regulations on pretty much anything. And the costs, even relative to local incomes, are a tiny minuscule fraction of what you pay in the US. I don't know if there's a causal relationship there - but such a relationship definitely exists. It's both the reason that medical tourism exists and the reason that places like Costa Rica, which has a purchasing power adjusted GDP of just $12,382 per capita, actually have greater life expectancy than we do.
I've always been extremely liberal, but having traveled the world a lot I've started to become more and more averse to governmental regulations. The United States has some of the strictest regulations in the world in many fields, but you'd be surprised how little a difference there is between our amazing country and developing nations, even what we'd refer to as the 'third world.' Government is absolutely a force for good, but it can also be exploited by private interests and turned into the opposite. I think the biggest protection against a corrupt government is keeping the distance (literally and figuratively) between the government and its constituents as small as possible. In the US it takes millions of dollars to effectively run for congress and unsurprisingly you end up with a situation where the majority of congressmen are millionaires. And they're not only millionaires but people entirely detached from the people they're supposed to represent - again physically and figuratively.
I think much strong state powers and much weaker federal powers would be something that could greatly benefit the US. Allow Ohio to have its own set of rules and regulations (or lack thereof) for medicine and insurance, and another for California. And let people decide where they'd prefer to take their business and ultimately let us see, existentially, which works out better. This is most obvious today with things like drug laws. The fact that the federal government is attempting to stop states from legalizing, or even decriminalizing, possession or consumption of various natural compounds is just silly. I'm not actually taking a pro or con stance there, but rather that this is something that the people most directly affected by these things should get to decide - not some centralized government so far detached from the people it is legislating against.
(Score: 0) by Anonymous Coward on Sunday August 13 2017, @05:32AM
Take this exact case for an example. I'm certain there is probably some law on the books that made what CVS is doing illegal. Perhaps it's the Orwell fair pricing and consumer confidence act of 1984. But one of two things will happen here, with our hypothetical regulation. Either CVS would end paying a fine which would be a small fraction of the additional profits they garnered, or CVS would manage to successfully argue that the law didn't apply to them because reasons. This story plays out over and over and over. The only people said law ends up applying to are those who are either not wealthy or well connected enough to successfully defend themselves.
Bring things down to a smaller scale and it becomes more and more difficult for companies or individuals to escape the consequences of their actions. Alice Walton, one of the richest individuals in the world, was put through a drunk driving test and arrested for breaking a law at the local level. But it eventually got thrown out and one can only imagine what happened to the police officer who did arrest her, thanks to her connections with people far detached from that officer who's interest is not in appeasing rich connected individuals - but just doing his job. The fewer people in the pipeline who see value in pandering, the more concrete laws become. Our federal government adds an entire layer of people who are for the most part only in the position they are thanks to pandering - and they're at the top of society. That, in effect, means society is for sale.
(Score: 2) by Justin Case on Sunday August 13 2017, @02:11PM
I think that's why we have 50 separate states. But federal power has gradually expanded. Or sometimes not so gradually. Consider the civil war. By spinning the propaganda to the evils of slavery, the winners shut down any further discussion of states' rights.
Imagine if we had 50 simultaneous experiments running. One state has "single payer" (actually taxpayer) health insurance. Another has highly regulated doctors and hospitals. Another is more or less a free for all, but the poor and careless die.
We would quickly see through the rhetoric to find out what really works.
And fairly soon, the other 49 states would converge toward the winning solution. With less debate, because everyone would have seen the truth and lies of the talking points.
(Score: 5, Informative) by kurenai.tsubasa on Saturday August 12 2017, @08:18PM (2 children)
This accurately describes the entirety of the US medical system.
My insurance company gives my pharmacy some made-up numbers about what different things really cost and how lucky I should feel that I have their “services” to be included on the receipt at the pharmacy, but knowing what my meds cost outside of the US scam system, I cannot figure out how they're getting those numbers unless they're pulling them out of their asses. They never include who the manufacturer is, either, and I have no say in that choice anyhow. All I can do is accept whatever they give me at the pharmacy without any clue who made it or in what country.
(Score: 3, Informative) by http on Sunday August 13 2017, @12:51AM (1 child)
Many Americans object to socialized medicine becaue they mistakenly think the prices they pay for medical goods and services are the actual cost.
I browse at -1 when I have mod points. It's unsettling.
(Score: 0) by Anonymous Coward on Sunday August 13 2017, @11:27PM
How about the ones who've actually lived under socialised medicine elsewhere, and have come to understand by personal experience that it just sucks a different flavour of dick, and on reflection prefer the american flavour?
Nah, can't be. Everyone who's lived under single payer is a totally rabid advocate for it! Down with americorporagreedsploitation!
(Score: 5, Insightful) by BK on Saturday August 12 2017, @08:34PM (1 child)
Secret Scheme? Anyone who watches (and visits a pharmacy from time to time) knows that this has been going on for years. Pharmacies are happy to collect both co-pays and reimbursements from insurance if they can. Remember when Walmart (hate them all you want but the press release is real) cut the CASH price of prescriptions to $4 back in '06 [walmart.com]? Anyone who has charged a 'copay' of more than $5 for those items since then has been scamming. Which is basically everyone.
There are lots of problems with the USA healthcare delivery system, but among them is that there is absolutely no price transparency anywhere in the system. Fix that and you'll fix a lot... and you'll have better visibility as to where the rest of the problems are.
...but you HAVE heard of me.
(Score: 2) by Magic Oddball on Sunday August 13 2017, @06:59AM
People didn't need to go to Walmart for that, thankfully — Target was also doing it up until CVS took over their pharmacies, except IIRC they charged $4 flat.
(Score: 5, Insightful) by Justin Case on Saturday August 12 2017, @08:46PM (9 children)
I don't hear ANY of the multiple parties in the "healthcare" (actually health insurance) debate proposing to fix what is really wrong:
* You cannot know the real price of a thing
* You cannot know what it is going to cost you until after you buy it
* The fake prices thrown around are totally absurd and meaningless
I frequently see the actual health care providers claiming prices of 10 to 100 times what they actually end up getting paid. This screws the cash customer making it impossible to tell the insurance middleman to go to hell.
Recently I went for a necessary treatment. The provider claimed it cost I don't remember something like $695.00. I paid my $80.00 copay and the insurance company paid less than a dollar! How is it even worth handling the paperwork?
A few times you will find someone who will lift the veil. There's a medication that is $30 a month (my standard copy) if I go through insurance, but TWELVE dollars for THREE months if I pay cash. Plus I don't have to stop by the pharmacy every month.
To add insult to injury, standard operating procedure for insurance companies seems to be reject any claim and make the beloved customer fight tooth and nail to get the coverage for which we already drastically overpaid.
Whatever the next system is, I say not ONE tax dollar to insurance companies. If we are going to have tax money spent to help people, at least give it to the healthcare providers who help the people NOT THE INSURANCE COMPANIES! NUKE THEM TILL THEY GLOW! Then piss on the ashes.
(Score: 1, Insightful) by Anonymous Coward on Saturday August 12 2017, @10:03PM (3 children)
The entire healthcare system from meds to doctors fees needs to be overhauled, and the frigging insurance industry needs to go away. I've paid $750/month cash (no insurance) for a single Rx that probably cost $15 to make. Raping the patients for as much money as possible is nothing but greed.
(Score: 2) by kaszz on Saturday August 12 2017, @10:45PM (2 children)
Can't you order that from a Canadian pharmacy?
Btw are they good on quality?
(Score: 2) by Magic Oddball on Sunday August 13 2017, @07:14AM (1 child)
That used to be the case, but the US government pressured Canada to help it crack down aggressively on the industry, so a lot of medications simply stopped being available and the remaining ones started costing a lot more money.
(Score: 2) by kaszz on Sunday August 13 2017, @07:21AM
Will Japanese, European, Australian or New Zealand pharmacies work?
Or is it possible to setup a physical mailbox inside Canada and order to that. And then re-mail it?
(Score: 2, Informative) by Anonymous Coward on Saturday August 12 2017, @10:38PM (2 children)
Hillarycare and its followon Obamacare are basically giant love notes to the insurance companies. Anyone who has actually read the bills would know that. These are not health care bills. They are mandated insurance bills.
I can today right now go buy fairly awesome insurance for about 30-50 bucks a month. However it is not ACHA. What do I get for my ACHA insurance? 7500 deductible catastrophic insurance for 9000 bucks a year. In all ways it is a worse plan.
(Score: 3, Insightful) by Whoever on Saturday August 12 2017, @11:06PM (1 child)
How much were you paid for that post?
So, yes, you may be able to buy insurance for 30-50 bucks/month (although I doubt even this). But awesome? No. It will be far worse than the minimum Obamacare required insurance. Why do you think it is so cheap?
(Score: 4, Insightful) by Justin Case on Saturday August 12 2017, @11:25PM
When I was self employed I used to pay exactly that: $30 a month for catastrophic insurance with a million dollars per year of coverage.
But it didn't pay for minor things like band-aids, aspirin, or having my temperature taken. I paid the small expenses out of pocket with the money I saved on premiums.
(Score: 2) by kaszz on Sunday August 13 2017, @07:25AM (1 child)
Buy and then ask to cancel the buy. Then the receipt would tell?
Cumbersome, but you didn't make this mess.
(Score: 2) by Justin Case on Sunday August 13 2017, @01:57PM
No, you go to the doctor and two months later you get a statement that says yeah, that's going to cost you $279 because [microscopic incomprehensible fine print].
You can't return your doctor visit.
(Score: 2) by jmorris on Saturday August 12 2017, @09:21PM (3 children)
The Bloomberg, didn't bother with the others who probably just cut/pasted, article was all emotion to push the plaintiff (and the NGOs behind them) agenda and almost entirely fact free. This is how the MSM spins The Narrative with fake news. There was no news there, only rabble rousing.
Journalists would have dug into the press release they were given to propagate and added some facts. What exactly IS the relationship between big pharma, the "pharmacy benefit managers" and the retail chains? Who is hosing who, where does the money go? The Blue Check Mafia lacks even the most basic journalistic instincts, like knowing to always "follow the money." This article is so one sided that we don't even get a stated (i.e. corporate PR dept bullshit babble) reason for the policy from the other sides. And can we notice the elephant in the room here? Who the Hell is paying $166 for a drug if they have real insurance? Is that really a thing in CA? What is the real story here? If you leave the emotion out, the article raises far more questions than it answers.
(Score: 2) by kaszz on Saturday August 12 2017, @10:47PM
It's not journalists working there, it's Goebbels clones being commanded from ûber-bofh of propaganda minsterium.
(Score: 3, Informative) by HiThere on Saturday August 12 2017, @11:40PM (1 child)
They're accusing CVS, so I tend to believe them. When they took over the local store from Longs I investigated a few of their house brand offerings (compared to the Longs brand). They kept about the same size bottle, but with a changed shape. They shaved a hair off the price, but decreased the number of pills in the bottle by 1/5.
I went elsewhere. I still go elsewhere. When they sell something, I expect it to be some flavor of scam. (Sometimes it doesn't appear to be any worse scam than elsewhere, admittedly, but that's what I expect. I've essentially never found it to be a better deal.)
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Wednesday August 16 2017, @12:41PM
Probably a good plan.
*Posted from the CVS corporate headquarters*
(Score: 2) by Snotnose on Saturday August 12 2017, @11:44PM
Back in the 90's I consulted, and often found myself on my wife's insurance plan. Plan administrators made my life a living hell. One day I needed my meds, red tape ensued, and I decided fuck it and asked how much the meds would cost (2 pills). They were cheaper than the co-pay.
Ever since I've always asked what my drugs would cost with and without my co-pay.
When the dust settled America realized it was saved by a porn star.
(Score: 5, Funny) by chromas on Sunday August 13 2017, @12:06AM
This is how they fund their budget for six-foot receipts.