Recently, a class action lawsuit was filed against Rite Aid for an alleged price scheme which artificially inflated “usual and customary” prices on certain prescription drugs. Here’s what we know about the Rite Aid class action, and how we can help out:
The complaint states that about 90% of all United States citizens are now enrolled in private or public health insurance plans that cover at least a portion of the costs of medical and prescription drug benefits. A feature of most of these health insurance plans is the shared cost of prescription drugs. Typically, when a consumer fills a prescription for a medically necessary prescription drug under his or her health insurance plan, the third-party payor pays a portion of the cost and the consumer pays the remaining portion of the cost directly to the pharmacy in the form of a copayment, coinsurance, or deductible payment.
In an effort to control their prescription drug costs, many insurance companies and third-party payors require consumers to purchase generic prescription drugs when available because generic drugs often cost less than the brand-name version. According to a report by the Generic Pharmaceutical Association, 89% of all prescriptions dispensed in the United States now are generic drugs. Consumers also save money when they purchase generic prescription drugs over more expensive brand-name versions because they pay a lower copayment, coinsurance, or deductible amounts for these generics.
Instead of reaping the benefits of these intended savings, the members of the class are paying much more for certain generic drugs than Rite Aid’s cash-paying customers who fill their generic prescriptions through Rite Aid’s discount generic drug program, called the “Rx Savings Program,” without using health insurance. A pharmacy cannot charge a consumer or report to a third-party payor a higher price for prescription drugs than the pharmacy’s “usual and customary” price. This price is referred to by Rite Aid and known throughout the pharmacy industry as the price that the pharmacy most commonly charges the cash-paying public. Indeed, Rite Aid’s practices violate federal and state regulations, including the Medicare Prescription Drug Benefit Manual, which defines the “usual and customary price” as “the price that an out-of-network pharmacy or a physician’s office charges a customer who does not have any form of prescription drug coverage for a covered Part D drug.”
Therefore, Rite Aid, instead of complying with this requirement, maintains an undisclosed, dual pricing scheme for the generic prescription drugs available through the RSP. Indeed, Rite Aid has used its Rx Savings Program as a mechanism to knowingly and intentionally overcharge consumers in excess of Rite Aid’s usual prices for these generic drugs.
For your convenience, a full copy of the complaint is embedded below:
If Rite Aid’s actions have affected you, please don’t hesitate to reach out to us. We’d be happy to help you take a step in the right direction to fight this issue and join the class action. Please send an email to ConsiderTheConsumer@gmail.com, find us on Twitter or Facebook, or even connect with us directly on our website! We look forward to hearing from you all.