A New Class Action Lawsuit Against Myer and Sprint pharmacies
Medicare Part B covers insurance premiums and costs for covered procedures. Part A is the supplement insurance which covers most of the non-urgent hospital services and nursing home care. Most of the medications and durable medical supplies are not covered under Part B. One of the few exceptions to this general rule is the blood thinener manufactured by Eliquis manufacturer.
Eliquis manufactures the blood thinner called Aldara. The company offers a “reduced cost” blood thinner called Aldara Clear through a Medicare Part B co-pay card. This co-pay card, also called the Preferred Provider Network (“PPN”), allows eligible patients to receive a lower co-pay premium for the prescribed medications called “Atenolol” and “Censodex”. Eliquis has marketed and sold these two medications under its own brand name in the United States since October 2021. In early 2021, it filed a Class Action Lawsuit against Medavac Corporation and CVS Pharmacy Inc., claiming that these two companies violated federal regulations regarding exclusions, limitations and contraindications, as well as other trade secrets related to the manufacture of Eliquis products.
A class action lawsuit can be filed in a number of different situations. In this case, the plaintiff’s lawyer, Robert D. Herman, claimed that Eliquis improperly classified its blood thinners, calling them” specialty drugs” rather than “preventive medicines” or “medicare items”. Also, there was evidence that Eliquis failed to provide adequate information to patients about its blood thinners, including the FDA’s website on prescribing them. After being granted summary judgment in the case, the court instructed the parties to develop an agreement whereby Eliquis would appropriately notify patients of its class status, the terms of its discounts on selected prescriptions, and contact information for a patient assistance program.
Myers patient assistance program is a discount plan run by the Florida-based Medicare insurance program. Eliquis was contracted to sell twenty-one different medications, including its blood thinner class. According to the complaint, Medicare denied Eliquis the opportunity to be marketed under the “preferred provider organization” or “reimbursement,” classifications set up by the government. Eliquis was also specifically excluded from the “morale increase” discount plan because the discount plan was only available to patients who received prescriptions at a “fractionated rate” of a single unit, not a “prices up to” a specific quantity, as was the case with Eliquis.
A class action lawsuit is filed by individuals who were similarly disrespected by Medicare when they applied for and obtained their prescriptions through the preferred provider organization’s program. Some plaintiffs were eligible for additional discounts on their medications through the “morale increase” discount program, but they were unable to use it due to the fact that they did not receive prescriptions from a particular pharmacy. Subsequently, they were unable to maintain adequate levels of health insurance because of the additional costs associated with increased deductibles and co-pays that resulted from their refusals. Furthermore, another plaintiff was able to obtain her requested medications, but was unable to utilize the free samples that she had access to because she could not purchase the medication from any of the participating pharmacies. A third plaintiff was ultimately unable to continue using the preferred provider organization because she was unable to continue buying her blood clots with the aid of her coupons, which expired at the end of the month.
The plaintiffs filed their complaint against Myer and Sprint pharmacy, claiming that they violated the anti-kickback provisions of the original Medicare Part B policy. Myer and Sprint were both found in violation of the bi-packs Act, which imposes severe restrictions on the quantities that pharmaceutical companies may charge consumers for their medications. As a result of the violations, the companies have been ordered to reduce the charges they would be able to make for these drugs to the point that they are in compliance with the regulations set forth by the Affordable Care Act. The case is being handled by the same attorney who handled the original lawsuit against Myer.
