Health Insurer and Pharmacy Benefit Manager Unlawful Retention of Prescription Drug Rebates – Class Action Investigation
Chimicles Schwartz Kriner & Donaldson-Smith LLP (CSK&D) is investigating reports that health insurance companies and pharmacy benefit managers (PBMs) wrongfully retain prescription drug rebates for drugs that were paid for, in full, by insureds in high-deductible health plans.
Pharmaceutical companies routinely provide health insurers and PBMs with prescription drug rebates to lower the cost of prescription drugs. CSK&D is investigating whether insurance companies and PBMs wrongfully pocket the rebates instead of giving them to the insureds who paid for the prescription drugs. These reported drug rebate practices are especially pernicious when carried out in the framework of high-deductible health plans, in which insureds or plan participants pay every single penny up until the deductible amount is reached – often thousands of dollars. For example, during the deductible period, the insured pays $200 for a prescription drug. The insurance company in turn gets a $100 rebate from the pharmaceutical company. Under the alleged scheme, the insurance company keeps the $100 rebate and does not send the $100 to the insured.
CSK&D is conducting an investigation to determine whether these practices are a breach of the insurance contracts and result in health insurers and PBMs being unjustly enriched to the great financial detriment of insureds. If you are in a high-deductible health plan and believe you purchased prescription drugs where rebates may have been paid (but not to you) by the drug company, or have paid in full for any of the following drugs, please contact CSK&D: