Ohio Attorney General Dave Yost has filed suit against Centene Corporation. (fotoguy22/Getty)
Ohio Attorney General Dave Yost has filed suit against Centene and several of its subsidiaries, alleging that they schemed to misrepresent pharmacy costs and gain overpayments from the state s Medicaid program.
According to the lawsuit, Centene subsidiary Buckeye Health Plan used sister companies Envolve Health Solutions and Health Net Pharmacy Solutions to administer its pharmacy benefit. Yost s office said it began to investigate their business practices as the arrangement raised questions.
In a statement, Yost s office said the investigation, which was conducted by outside counsel, found that the companies filed reimbursement requests for amounts that had already been paid by third parties, and failed to accurately represent costs to the Ohio Department of Medicaid.
Jeffrey Greenberg/Education Images/Universal Images Group via Getty Images This story is available exclusively to Insider subscribers. Become an Insider and start reading now.
Democrats are mulling including a provision to negotiate drug prices in an infrastructure bill.
Savings on government spending on prescription drugs could help pay for the infrastructure projects.
The government could save as much as $345 billion, according to the Congressional Budget Office.
Congressional Democrats want to crack down on drug prices to help pay for President Joe Biden s infrastructure package, according to several lawmakers, including House Speaker Nancy Pelosi.
Such a provision would be included in a package that lawmakers hope to pass as early as July 4 if they can gain enough support for it.
Mar 9, 2021 12:12pm
Eiger BioPharmaceuticals Zokinvy, recently approved by the FDA for ultrarare rapid-aging diseases that affect an estimated 600 children worldwide, is the most expensive drug in U.S. pharmacies in 2021, according to GoodRx.(Jacoblund)
Eiger BioPharmaceuticals in November snagged FDA clearance for Zokinvy for ultra-rare rapid-aging diseases that affect an estimated 600 people worldwide. Orphan drugs that treat small patient populations typically come with high prices, but Zokinvy’s sticker price now beats them all in U.S. pharmacies.
At an estimated monthly price of $86,000, or more than $1 million a year, Zokinvy’s now the most expensive pharmacy drug in the U.S. as of February, according to a list compiled by GoodRx. The ranking focuses on monthly prices and doesn’t include drugs administered by doctors.
Mar 4, 2021 3:40pm
Blue Cross and Blue Shield of Minnesota has filed suit against Vyera Pharmaceuticals. (Getty/Charles Wollertz)
Blue Cross and Blue Shield of Minnesota has filed suit against Vyera Pharmaceuticals, alleging that the drugmaker engaged in illegal pricing practices for its drug Daraprim.
In the suit, filed Thursday, the insurer says Vyera intentionally monopolized the market so it could increase prices on Daraprim a drug used to treat infections in immunocompromised patients such as those with HIV by more than 4,000%.
The suit names Vyera, which was formerly Turing Pharmaceuticals, alongside its parent company Phoenixus AG.
It also names former executives Kevin Mulleady and Martin Shkreli, who was dubbed the pharma bro by some in the media after rising in notoriety for acquiring Daraprim and increasing the price in 2015.
What is in store for healthcare under a Biden administration? Let’s look at the likely short-term, near-term and long-term changes to come over the next few months and years.