The recent report by The Wall Street Journal that CVS Caremark’s Medicare Part D prescription drug plans have been charging seniors more than the company said it would fits a familiar pattern.
According to the Journal, in late 2009 CVS Caremark’s SilverScript plans were being marketed to seniors with brand name drug prices that were on average 4% lower than what the company ever planned on providing. CVS Caremark chalked the problem up to a computer error.
CVS Caremark appears to have erected bureaucratic hoops through which patients must jump to recoup the overcharge. The form apology letter makes no mention of a potential refund, the Journal reports, adding that one patient was told by a CVS Caremark phone rep that in order to get a refund he must file a “grievance” and document where he saw the more attractive prices in the company’s marketing material more than five months ago.
“The burden should not be on the beneficiary to prove that’s why they chose the plan,” Judith Stein of the Center for Medicare Advocacy said in the article. She called for either a full refund to consumers or for CVS Caremark to honor the advertised price for the full year.
CVS Caremark already socked seniors with a 21% premium increase for its SilverScript Value plan for the 2010 plan year, according to Avalere Health LLC. So, for some seniors, their deal with CVS Caremark went from bad to worse. (By contrast, the Community CCRx Basic plan actually reduced premiums slightly, the same report found.)
While unfortunate for the affected patients, the disappearing nature of CVS Caremark “savings” is not unprecedented.
Prior to launching a formal investigation into the company, the U.S. Federal Trade Commission heard from the Hausers of North Carolina in a meeting arranged by NCPA. CVS Caremark managed the Hausers’ Medicare drug plan and steered their prescriptions to CVS Caremark which, according to WCNC-TV Newschannel 36, resulted in increased costs and forced them into the coverage gap (or “doughnut hole”) sooner.
And, earlier this year, Change to Win documented how patients with prescription drug coverage administered by CVS Caremark (and provided through the Federal Employees Health Benefits Program or FEHBP) face higher costs for generic drugs than uninsured patients. Specifically, the report found that FEHBP patients would pay more at CVS retail pharmacies for 85% of the generic drugs on CVS Caremark’s generic discount list for those without insurance.