Oct 5 UnitedHealth Group Inc has been
sued by three customers who accused the largest U.S. health
insurer of charging co-payments for prescription drugs that were
higher than their actual cost and pocketing the difference.
The lawsuit, filed Tuesday in federal court in Minnesota by
three UnitedHealth customers, seeks to represent a nationwide
class that it says could include "tens of thousands" of people
insured by UnitedHealth.
The lawsuit said Minnesota-based UnitedHealth and affiliated
companies charged customers co-payments for drugs that were
significantly higher than prices it negotiated with pharmacies
for those drugs.
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 lawsuit claims UnitedHealth's co-payments violate the
Racketeer Influenced and Corrupt Organizations Act (RICO), a
federal law used to target illegal conspiracies, and in some
cases also violate a federal law governing employee benefit
UnitedHealth spokesman Matt Wiggin said in an email that the
company had not yet been served with the complaint, and that
"pharmacy benefits are administered in line with the coverage
described in the plan documents."
(Reporting By Brendan Pierson in New York; Editing by David