Lawsuits: Health Care Insurers Engaged in Deceptive Copay Scheme

Multiple pharmacy copay class action lawsuits have been filed against certain health care insurers and affiliated pharmacy benefit managers (PBMs) after they allegedly engaged in fraudulent and deceptive “clawback” schemes to improperly overcharge consumers for prescription drugs. Consumers who purchased prescription drugs through one of the named defendants below may be able to seek compensation with the help of a consumer protection attorney.

If you or a loved one purchased a medication through a prescription drug program offered by one of the companies listed in the article below, or if you generally believe your prescription copays are higher than the actual cost of the drugs purchased, contact Attorney Group to learn about your options. We offer free, no obligation consultations. We can help answer your questions, and if you choose to pursue a claim we can connect you with an affiliated attorney who can assist you throughout the legal process.

Important: The time you have to pursue a claim is limited. Contact us for more information.

Clawback Schemes Generate Pure Profit While Increasing Costs

Multiple pharmacy copay class action lawsuits have been filed alleging that certain health care insurers, through “clawback” schemes, intentionally overcharge consumers for prescription drugs by charging full copay amounts that are higher than the cost consumers would pay if they did not have insurance.  This results in consumers with insurance allegedly paying more than they would have without insurance for the same prescription drugs.

Many Americans who are enrolled in private or public health insurance plans participate in a pharmacy copayment plan for their prescription drugs. The prescription drug plan typically pays a portion of the cost of the medication while the participant pays the rest to the pharmacy in the form of a copayment. “Clawback” schemes essentially defraud plan members through the imposition of hidden fees allowing insurance companies and pharmacy benefit managers to obtain pure profits while plan members end up paying more for their medications.

Defendants are certain health care insurance companies and pharmacy benefit managers affiliated with their pharmacy plan. Those insurance companies and affiliated PBM accused of defrauding plan members include:

  • UnitedHealth Group Incorporated
  • United Healthcare Services, Inc.
  • UnitedHealthcare Inc.
  • UnitedHealthcare Insurance Company
  • Optum, Inc.
  • OptumRx, Inc.

Class action cases have been filed against other insurance companies and PBMs, including Cigna HealthCare and Humana Inc.

Affected Parties May be Eligible for Pharmacy Copay Class Action Lawsuits

When insurance companies and their affiliates engage in fraudulent behavior, or otherwise commit unlawful or unfair trade practices, they could be liable for any damages that result. If a health care insurer or pharmacy benefit manager is found to have been participating in a deceptive “clawback” scheme, consumers who pay artificially inflated copayments for their medications may be able to recover the losses they suffered as a result of the defendants’ actions, along with other damages.

Individuals who have purchased prescription drugs through one of the named defendants or another insurer as a result of a “clawback” scheme may be eligible to pursue damages through a pharmacy copay class action lawsuit and are encouraged to seek the advice of an experienced attorney to learn more about their rights and remedies.

The Time You Have to Pursue a Claim is Limited. Contact Us Today.

For more information, contact Attorney Group. You can fill out the form on this page or contact us by phone or email.

After you contact us, an attorney will follow up to answer questions that you might have. There is no cost or obligation to speak with us, and any information you provide will be kept confidential.

Please note that the law limits the time you have to pursue a claim or file a lawsuit for an injury. If you think you have a case, you should not delay taking action.