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, Cigna Accused Of Cheating Prescription Drug Buyers.
