Interpreting your doctor bills can be a pain in the you know what. (To help, we’ve put together a guide of what to do when a big doctor bill hits you). But now a new lawsuit might cause you to pay extra attention to your bill at the pharmacy, too. A California woman is suing CVS for allegedly charging customers more for certain generic prescriptions if they pay with their insurance. You might want to keep tabs on this one if you’ve been using your insurance to purchase prescriptions at CVS, which has more than 9,600 locations. That’s because this lawsuit seeks class-action status. The plaintiff, Megan Schultz, claims in the lawsuit against CVS Health Corporation that she paid $165.68 for a prescription for a generic drug in July. If she would have bought it paying cash, and without using her insurance, though, it would have only cost her $92, according to the lawsuit. The lawsuit refers to CVS’ practice as a “fraudulent scheme.” “CVS never told her that paying cash would allow her to pay 45 percent less for the drug; instead, CVS remained silent and took her money—knowing full well that no reasonable customer would make such a choice,” says the lawsuit.
CVS Denies Accusations
CVS replied to the lawsuit in a statement and denied the allegations, saying that they’re based on “a false premise and are completely without merit,” according to NBC News. So, what’s with the discrepancy? The lawsuit says it’s a result of “Pharmacy Benefits Managers” acting as intermediaries between insurance companies and pharmacies. PBMs negotiate prices that insurance companies have to pay pharmacies. Pharmacies benefit from this because it drives more traffic into the stores, the lawsuit explains. The customer then pays the amount that the PBMs have negotiated, even if it’s more than the price of the drug, the lawsuit explains. "Co-pays for prescription medications are determined by a patient’s prescription coverage plan, not by the pharmacy,” the CVS statement provided to NBC News says. “Pharmacies collect the co-pays that are set by the coverage plans. Our pharmacists work hard to help patients obtain the lowest out-of-pocket cost available for their prescriptions.” CVS went on to deny that its PBM, CVS Caremark, does not engage in the practice of “co-pay clawbacks.” This one hasn't reached class-action status just yet. But if you're curious about other class-action lawsuits, there's a database of cases around the country. Also, if you suspect you're paying too much for your prescriptions, check a site like GoodRx to run some comparisons. [H/t: The Penny Hoarder]