The lawsuit is on hold while the parties negotiate a settlement, according to court filings. Through its lawyer, AllCare declined to comment. UnitedHealth declined to comment.
The U.S. government has begun to look into whether PBMs and health plans were blocking access to some pharmacies.
In November, the Centers for Medicare and Medicaid Services said it was concerned that health plans were manipulating the rules “in a way that inappropriately limits dispensing of specialty drugs to certain pharmacies.” It proposed rules to stop some of the practices in Medicare.
The Pharmaceutical Care Management Association, which represents PBMs, said in a in a January letter that the CMS proposal would undermine a “competitive and well-functioning” system and make it harder to keep drug costs down.
Patients with serious diseases should have a choice, says Jerry Flanagan, a lawyer at Consumer Watchdog. He has filed a lawsuit against CVS on behalf of HIV patients who claim the PBM’s requirements violate their privacy and access to trusted pharmacists. CVS said the the suit is without merit.
“If mail-order specialty pharmacies provide such great advantages, why not let patients choose for themselves?” Flanagan said.
This article was provided by Bloomberg News.