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by cachencarry
946 days ago
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I've never seen a pharmacy that works like that, they most likely just told you that because they didn't want to do the extra work rebilling. Or it's a CVS only thing, which would be pretty messed up considering they run their own insurance company and pbm. |
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> Much publicity has surrounded the use of gag clauses in contracts between insurance companies or their pharmacy benefit managers (PBMs) and pharmacies. These clauses prohibit pharmacists from voluntarily informing patients that their prescription medication may cost less if paid for directly by them instead of through their insurance.
> How often an insurance copayment exceeds the cash price for a prescription is not definitively known; however, Van Nuys and colleagues reported that such overpayments affected 2.2 million (23%) of 9.5 million prescription insurance claims from a single large insurer. Additionally, in a 2016 survey involving over 600 pharmacies, approximately 39% of respondents stated that a gag clause prevented them from informing patients about other payment options between 10 and 50 times in the last month.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293384/
Antitrust action when?