NEW YORK, Nov. 14, 2016 -- Scott+Scott, Attorneys at Law, LLP (“Scott+Scott”) has filed an action in the United States District Court – Western District of Kentucky against Humana, Inc. and Humana Pharmacy Solutions, Inc. (collectively, “Humana” or “Defendants”).
Defendants are health insurance companies along with pharmacy benefit managers (“PBMs”). The PBMs are retained by the health insurance companies, on behalf of the plan or third-party payors, to provide the pharmacy benefits to plan members, which includes, inter alia, establishing a formulary of drugs that will be covered, a network of pharmacies that will serve as participating pharmacies for plan participants to obtain their prescriptions, copayment amounts, coinsurance amounts, and deductibles.
Specifically, the action relates to Defendants engaging in a scheme to defraud plan members by artificially inflating the copayment of medically necessary prescription drugs well above the cost of the drug. Plan participants, including Plaintiff and the Class, pay inflated copayments to participating pharmacies in exchange for receiving their prescription drugs. Unbeknownst to the plan participants, Defendants artificially inflate the purported costs of the prescription drugs in the form of increased copayments and then “claw back,” or recoup, from the pharmacies a large portion of the copayments.
Class members are consumers who pay artificially inflated copayments for medically necessary, covered prescriptions that cost plan participants more than if they did not have insurance. If you would like addition information, please contact Michael Burnett of Scott+Scott ([email protected], (800) 404-7770, (860) 537-5537).
About Scott+Scott, Attorneys at Law, LLP
Scott+Scott has significant experience in prosecuting major securities, antitrust, and employee retirement plan actions throughout the United States. The firm represents pension funds, foundations, individuals, and other entities worldwide.
CONTACT: Michael Burnett Scott+Scott, Attorneys at Law, LLP (800) 404-7770 [email protected]


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