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Lawsuit Against UnitedHealth Put Insurers’ Practices Under Scrutiny

October 12, 2016
Reuters reports that UnitedHealth Group, the nation’s largest insurer, has been sued by three patients who’ve accused the massive insurance conglomerate of significantly over-charging them for co-pays for prescription drugs.

The report alleges the co-pays were far in excess of the actual cost of the drug and the insurer kept the difference.

According to Reuters:

“For example, the lawsuit claims, one class member paid a $50 co-payment for Sprintec, a contraceptive, while UnitedHealth paid the pharmacy only $11.65. The pharmacy was then required to hand the extra $38.85 over to UnitedHealth under its agreement with the insurer, the lawsuit said.

“The lawsuit claims that such a co-payment ‘is not a 'co-' payment for a prescription drug because the insurer is paying nothing,’ but is instead "a hidden additional premium.’

“The lawsuit says UnitedHealth has hidden this practice from its customers, forcing them to overpay for a wide variety of common, low-cost drugs.”

The report states that the plaintiffs are justifying their suit under the Racketeer Influenced and Corrupt Organizations Act (RICO), “a federal law used to target illegal conspiracies.”

Insurers and their discriminatory practices have been in the spotlight lately.

Harvard’s Center for Health Law and Policy Innovation filed civil rights complaints in several states against insurers who were discriminating against HIV/AIDS patients through extreme cost-sharing and specialty tiers. A California consumer group has also questioned Big Insurance’s scapegoating of prescription drugs as a false justification for raising premiums.

The insurance industry and its practices have also been targeted by state attorneys general from Florida to New York.

And In California, Blue Cross/Blue Shield lost their tax exempt status after the state found the insurer was storing billions of profits untouched in reserves—money that could’ve been used to cover prescription drugs or prevent premium increases.

In fact, the post-Affordable Care Act years have been a golden age of insurance industry profits. Big insurers have seen their profits explode—despite making you pay more for less coverage.

This steady stream of news on the insurance industry is why we started This site is meant to hold insurers accountable for their methods that restrict patient access to the innovations they need.