Class Action Moves Forward Against Cigna for Alleged Prescription Drug Overcharging
A federal judge in Connecticut ruled Monday for five plaintiffs, who sued alleging an artificial inflation of prescription drug costs. The case, which was not dismissed, will now go into discovery phase.
March 14, 2018 at 12:13 PM
4 minute read
A federal judge in Connecticut has denied most of Cigna Health and Life Insurance's claims in its request to dismiss a lawsuit which alleges it artificially inflated prescription drug costs in violation of the health insurance policies of its clients.
The Monday ruling by U.S. District Judge Warren Eginton means the class-action lawsuit against both Cigna and OptumRx Inc. will move forward. The insurance giant hired OptumRx as its pharmacy benefits manager to negotiate drug prices on behalf of Cigna and the Cigna network.
The October 2016 lawsuit, filed on behalf of five individuals who were covered by Bloomfield-based Cigna, alleges the two companies conspired over several years to make consumers pay higher prices for prescription drugs. The defendants allegedly misrepresented the costs of the drugs through increased charges to patients and then “clawbacks” to get a larger portion of patients' payments.
In his ruling, Eginton, who presides in Bridgeport, wrote, in part: “The court finds the plaintiffs have plausibly alleged more than an entitlement to lower-cost prescription drugs or breach of contract. … The complaint plausibly alleges the defendant CIGNA acted with scienter by alleging that it intentionally sought to charge excess amounts for prescription drugs and that it required the pharmacies to conceal from the insureds the amounts of the prescription drug costs.”
The lawsuit claims violation of the Employee Retirement Income Security Act and violation of the Racketeer Influenced and Corrupt Organization Act against both defendants. Eginton denied the motion to dismiss most claims, but did dismiss the RICO claim against OptumRx, while keeping the RICO claim against Cigna.
The lawsuit cites numerous alleged examples of the defendants and their agents taking clawback and/or so-called spread payments thousands of times each day from pharmacies across the country. Examples cited in the lawsuit show a class member in November 2014 paid a pharmacy a $20 co-payment for the prescription drug Amlodipine Besylate, 1,043 percent more than the actual $1.75 fee paid to the pharmacist. Without disclosing it to the consumer, the lawsuit alleges, the defendants clawed back the $18.25 overcharge.
In another cited case, a class member, also in November 2014, paid a pharmacy a $20 co-payment for the prescription drug Clopidogrel, a 468 percent premium over the actual $3.52 fee paid to the pharmacist. Again without disclosing it to the customer, defendants clawed back the $16.48 overcharge, the lawsuit states.
Craig Raabe, a partner with Izard, Kindall and Raabe in West Hartford and attorney for the plaintiffs, called Eginton's decision, “A great ruling for consumers. We now look forward to going into the discovery phase.”
That phase, Raabe told the Connecticut Law Tribune Tuesday, should determine “the mechanism and scope of the overcharges. Discovery will also determine how much in overcharges there have been and how many people were overcharged. We are seeking reimbursement for the class for all of the overcharges.”
Raabe said his office became involved in the case after getting a call from a client. “We received a complaint about drug overcharges, investigated the issue thoroughly and discovered the overcharge scheme set forth in the complaint,” he said.
Cigna is represented by Brian Shaffer of Morgan, Lewis & Bockius in Philadelphia. Shaffer did not respond to a request for comment Tuesday.
OptumRx, a subsidiary of the Minnesota-based United Health Care, is represented by Michelle Grant of Dorsey & Whitney in Minnesota. Grant also did not respond to a request for comment.
The five plaintiffs are Kimberly Negron, Daniel Perry, Courtney Gallagher, and Nina and Roger Curol. The plaintiffs are from four states: Massachusetts, New Jersey, Washington and Louisiana.
This content has been archived. It is available through our partners, LexisNexis® and Bloomberg Law.
To view this content, please continue to their sites.
Not a Lexis Subscriber?
Subscribe Now
Not a Bloomberg Law Subscriber?
Subscribe Now
NOT FOR REPRINT
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
You Might Like
View AllPlaintiffs Seek to Avoid Jurisdiction Fight in IVF Case, Challenge CooperSurgical in Connecticut
4 minute readPike Fuels Agrees to Pay $2 Million Settlement to Resolve Alleged New Haven Environmental Violations
2 minute readHigh-Flying Genetics Testing Firm GeneDx Hires Ex-Zoetis GC as Legal Chief
2 minute readApple Asks Judge to 'Follow the Majority Practice' in Dismissing Patent Dispute Over Night Vision Technology
Trending Stories
- 1Legal Events for Georgia Lawyers
- 2'There is No Time to Waste': Matt Gaetz Withdraws From AG Nomination
- 3The Growing PFAS Morass: Why Insurance Should Cover These Products Liability Claims
- 4Dallas Jury Awards $98.65M in Botham Jean Killing by Dallas Officer
- 5In Talc Bankruptcy, Andy Birchfield Skipped His Deposition. Could He Face Sanctions?
Who Got The Work
Michael G. Bongiorno, Andrew Scott Dulberg and Elizabeth E. Driscoll from Wilmer Cutler Pickering Hale and Dorr have stepped in to represent Symbotic Inc., an A.I.-enabled technology platform that focuses on increasing supply chain efficiency, and other defendants in a pending shareholder derivative lawsuit. The case, filed Oct. 2 in Massachusetts District Court by the Brown Law Firm on behalf of Stephen Austen, accuses certain officers and directors of misleading investors in regard to Symbotic's potential for margin growth by failing to disclose that the company was not equipped to timely deploy its systems or manage expenses through project delays. The case, assigned to U.S. District Judge Nathaniel M. Gorton, is 1:24-cv-12522, Austen v. Cohen et al.
Who Got The Work
Edmund Polubinski and Marie Killmond of Davis Polk & Wardwell have entered appearances for data platform software development company MongoDB and other defendants in a pending shareholder derivative lawsuit. The action, filed Oct. 7 in New York Southern District Court by the Brown Law Firm, accuses the company's directors and/or officers of falsely expressing confidence in the company’s restructuring of its sales incentive plan and downplaying the severity of decreases in its upfront commitments. The case is 1:24-cv-07594, Roy v. Ittycheria et al.
Who Got The Work
Amy O. Bruchs and Kurt F. Ellison of Michael Best & Friedrich have entered appearances for Epic Systems Corp. in a pending employment discrimination lawsuit. The suit was filed Sept. 7 in Wisconsin Western District Court by Levine Eisberner LLC and Siri & Glimstad on behalf of a project manager who claims that he was wrongfully terminated after applying for a religious exemption to the defendant's COVID-19 vaccine mandate. The case, assigned to U.S. Magistrate Judge Anita Marie Boor, is 3:24-cv-00630, Secker, Nathan v. Epic Systems Corporation.
Who Got The Work
David X. Sullivan, Thomas J. Finn and Gregory A. Hall from McCarter & English have entered appearances for Sunrun Installation Services in a pending civil rights lawsuit. The complaint was filed Sept. 4 in Connecticut District Court by attorney Robert M. Berke on behalf of former employee George Edward Steins, who was arrested and charged with employing an unregistered home improvement salesperson. The complaint alleges that had Sunrun informed the Connecticut Department of Consumer Protection that the plaintiff's employment had ended in 2017 and that he no longer held Sunrun's home improvement contractor license, he would not have been hit with charges, which were dismissed in May 2024. The case, assigned to U.S. District Judge Jeffrey A. Meyer, is 3:24-cv-01423, Steins v. Sunrun, Inc. et al.
Who Got The Work
Greenberg Traurig shareholder Joshua L. Raskin has entered an appearance for boohoo.com UK Ltd. in a pending patent infringement lawsuit. The suit, filed Sept. 3 in Texas Eastern District Court by Rozier Hardt McDonough on behalf of Alto Dynamics, asserts five patents related to an online shopping platform. The case, assigned to U.S. District Judge Rodney Gilstrap, is 2:24-cv-00719, Alto Dynamics, LLC v. boohoo.com UK Limited.
Featured Firms
Law Offices of Gary Martin Hays & Associates, P.C.
(470) 294-1674
Law Offices of Mark E. Salomone
(857) 444-6468
Smith & Hassler
(713) 739-1250