PBM Express Scripts Did Not Pass Along Rebates to New York's Employee Health Program, Lawsuit Alleges
KaiserNetwork.org
August 5, 2004
New York Attorney General Eliot Spitzer (D) on Wednesday filed suit against pharmacy benefit manager Express Scripts which manages drug benefits for New York state employees - alleging
the company defrauded the state of up to $100 million over five years, USA Today reports (Appleby, USA Today,8/5). Spitzer and state Civil Service Commissioner Daniel Wall allege
Express Scripts violated its $600,000 contract to negotiate lower drug
prices for state workers and pass the rebates on to the state (AP/Long Island Newsday,8/5). According to the lawsuit, filed with the New York State Supreme Court, Express Scripts kept millions of dollars in rebates negotiated with pharmaceutical companies that should have gone to the state by
classifying them as "administrative" or "management" fees.
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20 States Investigating Practices of PBM Express Scripts, Company Officials Say
KaiserNetwork.org
July 29, 2004
Officials for Express Scripts,the third largest U.S. pharmacy benefit manager, on Wednesday announced
that 20 states have launched investigations into the company's business
practices, the St. Louis Post-Dispatch reports. New York Attorney General Eliot Spitzer (D) on July 12 sent Express Scripts a notice of a proposed lawsuit, company officials said.
According to the notice, Express Scripts breached a contract with the
state and violated other civil laws; the notice alleges that the
company switched patient medications and did not pass on the savings.
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Caremark Rx Business Practices Investigated by 19 State AGs
KaiserNetwork.org
July 06, 2004
Officials for Tennessee-based Caremark Rx,
the second-largest U.S. pharmacy benefit manager, on Friday announced
that attorneys general from 19 states have launched an investigation
into company business practices, the AP/Miami Herald reports (McDowell, AP/Miami Herald,
7/3). Caremark officials said that the company on Thursday received an
information request called a "civil investigative demand" from
Washington state Attorney General Christine Gregoire (D). In a
statement, Caremark officials said that Gregoire requested information
"pursuant to consumer-protection statutes and business practices"
related to the company and recently acquired PBM AdvancePCS.
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PBM Medco To Pay $5.5M To Settle Charges It Did Not Pass Along All Rebates to Massachusetts
KaiserNetwork.Org
April 26, 2004
Medco Health Solutions,
the nation's largest pharmacy benefit manager, has agreed to pay
Massachusetts $5.5 million to settle allegations that it failed to pass
along to the state more than half of the rebates it negotiated with
drug makers, according to documents expected to be filed in U.S.
District Court in Philadelphia on Monday, the Boston Globe
reports. The state hired Medco in 1997 to manage prescription drug
benefits for nearly 200,000 state employees and retirees, negotiate
discounts from manufacturers, maintain a preferred drug list, process
billing and perform other tasks. Under the contract, Medco agreed to
give the state "nearly all of the payments" it received from drug
makers for placing their products on the preferred drug list or for
favoring their drugs over others on the list, the Globe
reports. According to a complaint by state Attorney General Thomas
Reilly (D), Medco passed along only about $9 million in rebates and
kept $10 million.
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PBM Reimbursement Practices Contributing to Rising Prescription Drug Costs,
Study Says
KaiserNetwork.org
January 16, 2004
The disparity between the amounts that pharmacy benefits managers charge
clients and reimburse pharmacies is "contributing to the rapid rise in health
care costs," according to a pilot study in the Journalof the American
Pharmacists Association, the Newark Star-Ledger reports.
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New York Times Examines Business Practices of Pharmacy Benefit Managers
KaiserNetwork.org
December 11, 2003
The New York Times on Thursday examined business practices of pharmacy benefits
managers, including "millions of dollars in payments" that pharmacy benefits
managers make " to important customers when contracts with them are signed,"
according to industry executives and consultants. Some industry officials say
that payments related to contract provisions may be driving up the cost of
business unnecessarily.
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Federal Prosecutors Expand Lawsuit Against PBM Medco, Bring Charges Against Two
Executives
KaiserNetwork.org
December 10, 2003
The Justice Department on Tuesday filed an amended complaint against New Jersey
based pharmacy benefit manager Medco Health Solutions, alleging that the
company paid an insurer $87.4 million in kickbacks to secure a contract , the
Wall Street Journal reports.
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Drug Plan Managers Accused of Skimming
The Hartford Courant
July 18, 2003
Prescription benefit-plan managers are supposed to use the buying power of
millions of insured workers to win discounts on drug prices. But in suits filed
across the country, lawyers charge that the companies are pocketing more than a
fair share of the savings.
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