Cigna Sued for Cheating Policyholders On Prescription Co-Pays

A policyholder has sued Cigna Insurance Company for cheating her and other insureds on the co-pays for many prescriptions. The claims most specifically regard "clawback fees" it collects from pharmacies that, according to the suit, it requires to charge insureds a co-pay amount greater than what the drug would cost without insurance at all.

Here's an example of how this works according to the lawsuit: a Cigna insured gets a prescription filled at a pharmacy and the pharmacy collects a $20 co-pay from the insured; however, Cigna is contractually obligated to pay the pharmacy some amount less than $20 for filling the prescription, say $1.75. In this instance, Cigna "claws back" $18.25, the difference between the $20 copay charged the insured and the $1.75 that Cigna actually had to pay the pharmacy to cover the prescription. Essentially, according to the lawsuit, Cigna is using pharmacies as a means to deceive insureds into overpaying for prescriptions by large, large margins.

There is substantial coverage of this important lawsuit: Cigna Prescription Drug Fee Lawsuit Alleges Overcharging Scheme, Consumer Fraud Class Action Filed Against Insurance Company, and Cigna Accused Of Cheating Prescription Drug Buyers.

The lawsuit is pending in federal district court in Connecticut: Negron v. Cigna Corp., D. Conn., No. 3:16-cv-01702.