A Charlotte couple expects to share in a $5.25 million settlement reached by the federal Department of Justice with a national pharmacy chain accused of misrepresenting prices to senior citizens in the Medicare Part D prescription drug program.
Max and Jan Hauser were plaintiffs in one of two lawsuits filed in 2009 against RxAmerica, a subsidiary of CVS Caremark, under the False Claims Act.
The lawsuits alleged that RxAmerica misrepresented to seniors the cost of prescription drugs on Medicare’s online “Plan Finder” that is used by seniors to compare the pricing and benefits of different Medicare Part D plans.
RxAmerica has agreed to pay $5.25 million to resolve the charges of having misrepresented the costs and submitted false claims to the government in regards to its Advantage Freedom Plan.
In their lawsuit, the Hausers said they had reviewed their insurance plan’s Explanation of Benefits form and realized that RxAmerica was charging higher prices for their drugs than had been represented on the Plan Finder.
Because of that difference, the Hausers’ used their Part D benefits more quickly than expected, and Max Hauser was forced into the so-called “doughnut hole,” which meant he had to start paying for his drugs out of pocket.
The Hausers’ lawsuit was consolidated with a similar lawsuit brought by another whistleblower in New York. That plaintiff had independently noticed that RxAmerica was charging more money to the Part D Plan consumers than it had represented on the Plan Finder.
Jan Hauser, 71, said she and her husband were contacted by a lawyer, who encouraged them to file the complaint after reading an Observer article in 2009 that described the difference in drug prices they were seeing.
She said they had been prohibited from talking about the lawsuit for four years, and they’re glad to have a resolution. “It was too important to senior citizens to let this case die,” she said. “I’m just so thankful that it’s over.”
Jan Hauser said the settlement should show other seniors that it’s important to review their Explanation of Benefits forms to make sure their Part D plans are charging what they said they would charge.
She and her husband don’t know yet how much money they’ll receive from the settlement, or when. “I just know that it’s coming down the pike.”
In a written statement, CVS Caremark said RxAmerica “expressly denied any liability” as part of the settlement.”
The statement says CVS Caremark has cooperated fully with the federal government and has worked on a “corrective action plan” that has been monitored by Medicare, which has found the company “had consistently submitted accurate pricing data to (Medicare) throughout 2009 and 2010.”