Massachusetts Attorney General Maura Healey announced that a pharmacy benefits manager, Health E Systems, has agreed to pay $275,000 for allegedly failing to follow prescription pricing procedures that are designed to prevent overcharges in the workers’ compensation insurance system.
The Massachusetts’ workers’ compensation system sets limits for the cost of prescriptions for injured workers and requires companies to validate prices against certain regulatory benchmarks before processing their charges.
According to the , filed this week in Suffolk Superior Court, Health E Systems allegedly failed to follow those procedures when applying prices for certain injured worker prescriptions at various retail outlets, including some prescriptions filled by injured workers at Boston CVS, Walgreen’s and RiteAid locations.
Health E Systems accepted the terms of the resolution without admitting any facts, liability or wrongdoing.
This case is part of an ongoing review by the attorney general’s office into prescription pricing procedures in the workers’ compensation system. Healey has now reached settlements with Walmart, Express Scripts, , , , and workers’ compensation pricing procedure violations totaling more than $16 million.
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