United Healthcare profiting on CoPays

samantha severyn

A new lawsuit brought against United Healthcare – one of the largest providers in the U.S.- claims violations of the Federal RICO Act. The alleged violation stems from a pharmacy filling a prescription of a United Healthcare insured patient, charging them more than the cost of the drug, and then giving the extra money charged back to United Healthcare.

According to a story in Reuters, “For example, the lawsuit claims, one class member paid a $50 co-payment for Sprintec, a contraceptive, while UnitedHealth paid the pharmacy only $11.65. The pharmacy was then required to hand the extra $38.85 over to UnitedHealth under its agreement with the insurer, the lawsuit said.”

The lawsuit has been filed in Federal Court in Minnesota. A representative of United Healthcare says they have not yet been served with the complaint in the case.

The lawsuit also states this practice has been hidden from customers in the United Healthcare system and has resulted in an overpayment on a wide variety of low-cost drugs.