STAT+: Pharmalittle: J&J sues wholesalers and a pharmacy over fake HIV meds; Rite Aid to pay $123 million to Humana for inflating drug prices

Rite Aid was ordered to pay nearly $123 million to Humana for allegedly seeking inflated reimbursements for prescription drugs.

Top of the morning to you. Another busy day is unfolding here on the Pharmalot campus, where we are mulling over our cluttered calendar and plotting our next moves. No doubt, you can relate. After all, this is only the middle of the week and there is much to be done. This calls, as you may imagine, for a hot cup of stimulation. We are enjoying the ever-tasty pumpkin spice for now, for those who track this sort of thing. As always, you are invited to join us. Meanwhile, here are some tidbits. The world is a busy place, yes? Hope you make your way today. …

Rite Aid was ordered by an arbitrator to pay nearly $123 million to Humana, one of the largest health insurers in the U.S., for an alleged scheme in which the retailer sought reimbursement for prescription drugs at inflated prices, STAT reports. Many of the nation’s largest drug store chains and health plans have gone to court to settle such disputes. At issue in these cases is a behind-the-scenes practice in which prescription-drug claims are submitted to health insurers for reimbursement. Typically, a pharmacy must submit claims reflecting its “usual and customary” price, which is paid by cash-paying customers and acts as a ceiling for reimbursement by a health insurer.

Continue to STAT+ to read the full story…