UnitedHealth Group
Pharmacies file antitrust suit against massive drug middleman
A class-action suit has been filed in federal court on behalf of community pharmacies claiming that health giant CVS has used its dominance as a drug middleman to force pharmacies to pay large, after-the-fact fees in Medicare transactions. The suit was filed last week in Seattle on behalf of Osterhaus Pharmacy, which until last year […]
Feds expand probe into new layer of drug middlemen
The Federal Trade Commission this month announced that it was expanding its probe into drug middlemen — companies accused of increasing the cost of prescription drugs through secretive, one-sided arrangements with drugmakers and pharmacies. Specifically, it added a third company created by one of the biggest middlemen to its investigation. The commission, which polices anti-competitive […]
Newest federal regulator wants the little guy to be the focus of antitrust enforcement
From groceries to prescriptions to paychecks, the modern American business landscape makes it increasingly difficult for poorer Americans to get what they need to survive, Alvaro Bedoya, the newest member of the Federal Trade Commission, said in an interview late last month. The consequences have taken the form of food and pharmacy "deserts" and in a paucity of jobs that pay a living wage. "I want to focus on the folks at the bottom of the ladder and are trying to move up and not fall off," he said.
Health care giant confirms $15M settlement — two days after denying it
A prescription middleman on Friday confirmed that it has promised to pay Ohio $15 million to settle fraud claims against it. When the state announced the deal two days earlier, the company denied it had been finalized. Ohio Attorney General Dave Yost on Wednesday announced that pharmacy benefit manager OptumRx had agreed to pay $15 […]
Pharmacy middleman agrees to pay Ohio Workers’ Comp $15M, attorney general says
OptumRx, a huge pharmacy middleman, has agreed to pay the Ohio Bureau of Workers Compensation $15 million to settle claims that it overbilled the system between 2015 and 2018, Attorney General Dave Yost announced Tuesday.
Antitrust regulator takes aim at drug middlemen
The newest member of the Federal Trade Commission last week said that for decades his agency hasn’t served the historical mission of the agency — fairness. And in decrying the rise of megacorporations that dominate vast ranges of services in some economic sectors, he cited pharmacy middlemen as exhibit A. Alvaro Bedoya in May was […]
With new acquisition, CVS to get bigger and broader, raising concerns
When CVS Health announced last week that it was buying Signify Health for $8 billion, executives with both companies said it will help them to more effectively deliver care. But some observers are concerned that it means CVS and rival UnitedHealth Group are extending their dominance into yet another aspect of American health care. Dallas-based […]
Feds to probe drug rebates
The Federal Trade Commission last week announced what some observers believe could be a game-changer when it comes to the rising cost of prescription drugs. The agency — which is meant to protect fair competition — said it would look into the murky practice by which drugmakers grant rebates and other fees to insurer-owned pharmacy […]
Medicaid director owned stock in companies she awarded huge contracts
Ohio Medicaid Director Maureen Corcoran won’t discuss them, but state ethics filings she submitted on Sunday showed that she continued to own stock in three huge health care companies last year — the same year she negotiated and signed billion-dollar contracts with their subsidiaries. Outside ethics experts have said it’s a clear conflict of interest […]
Government watchdog: Health care giants improperly denied Medicare benefits
The health care companies offering Medicare Advantage plans improperly denied services and payments at what might seem an alarming rate during a one-week test period in 2019, according to a government report released last week. The companies — many of which are also major players in the Ohio Medicaid system — improperly denied payment 18% […]
Louisiana sues health care company over practices under investigation in Ohio
Louisiana is suing health care giant UnitedHealth over several business practices, saying it is seeking “to recover billions of dollars in inflated prescription-drug prices” for the state Medicaid program. Among its allegations, the state accuses the company of gaming federal oversight reports meant to ensure that at least 85% of the money it gets from […]
Mississippi House votes to cut ties with provider accused of fraud
The Mississippi House of Representatives last week voted overwhelmingly to cut ties with a Medicaid provider that last year agreed to pay the state $55 million to settle claims that it fraudulently inflated the cost of prescription drugs. Ohio is the only state to actually sue over such claims and last year St. Louis-based Centene […]