Express Scripts to pay $3.2 mln to settle Massachusetts overcharge claims

(Reuters) – Pharmacy profit supervisor Categorical Scripts Inc has agreed to pay $3.2 million to settle claims that it overcharged Massachusetts’ staff’ compensation insurance coverage system for pharmaceuticals, Massachusetts Legal professional Basic Maura Healey introduced Monday.

Beneath the settlement, Categorical Scripts, a subsidiary of Cigna Corp, additionally agreed to implement new protocols to make sure that it complies with the state’s drug pricing rules. It didn’t admit wrongdoing.

Categorical Scripts didn’t instantly reply to a request for remark.

“Employers want a staff’ compensation system that’s purposeful, clear, and reasonably priced,” Healey stated in a press release. “Our workplace will take motion to make sure pharmacy advantages managers observe procedures and don’t drive-up prices in our staff’ compensation system.”

Beneath Massachusetts legislation, staff injured on the job are entitled to advantages together with pharmaceuticals, whose costs are pegged to federal Medicare reimbursement charges and to a state-set benchmark.

The state alleged that Categorical Scripts didn’t take into consideration these benchmarks in setting costs for prescriptions disbursed at some CVS Well being Corp, Walgreens Boots Alliance Inc and Ceremony Help Corp pharmacies. Pharmacy profit managers like Categorical Scripts are intermediaries that negotiate costs with drugmakers and pharmacies on behalf of well being plans.

Massachusetts reached the same settlement in February with UnitedHealth Group Inc’s pharmacy profit supervisor OptumRx. It has additionally reached settlements with the three pharmacy operators totaling $10 million over associated allegations.

The case is Within the Matter of Categorical Scripts Inc, Suffolk Superior Courtroom, No. 2284CV02520.

For Massachusetts: Assistant Legal professional Basic Glenn Kaplan

For Categorical Scripts: Sarah Hellmann of Husch Blackwell

Learn extra:

UnitedHealth unit settles Mass. drug overcharge case for $5.8 mln

Walgreen settles Massachusetts drug overcharging probe for $5.5 mln

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