Oxford Health Insurance Prescription Overcharges ERISA Class Action

The complaint for this class action claims that Oxford Health Insurance, Inc. (OHI) arranged with pharmacies to overcharge patients for prescription drugs and return the overcharges as “clawbacks” to Oxford, in violations of the terms of their health insurance plans. According to the complaint, the insurer’s actions violate the Employee Retirement Income Security Act (ERISA)  Read more

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Neiman Marcus Health Plan Mental Health Parity ERISA Class Action

According to the complaint, three-year-old FA has autism spectrum disorder (ASD) and needs Neurodevelopmental Therapy (NDT) and Applied Behavior Analysis (ABA) therapy. Unfortunately, the complaint alleges that the health plan he’s on covers only speech, occupational, and physical therapy for “non-chronic conditions, and acute illnesses and injuries” but does not cover those same services for  Read more

Anthem Denial of Benefits for Microprocessor Controlled Prostheses Class Action

Defendant Anthem is one of the largest health insurers in the US, and defendant Anthem UM is its claims administrator. The two companies together develop Medical Policies and make decisions on which claims are approved and which are denied. One of their policies is the denial of claims for microprocessor-controlled lower limb prosthesis, the complaint  Read more

EpiPen Pharmacy Benefits ERISA Class Action

Pharmacy benefit managers (PBMs) OptumRX, ExpressScripts, and CVS Caremark have more than $200 billion per year in revenue and control almost 80% of the industry—and the complaint for this class action alleges that they do it by engaging in schemes for their own profit, violating their fiduciary duties to health plan consumers. Over time, the  Read more