ROC Weekly News Bites

Drug Companies Win Lawsuit Re: Opioids, MultiPlan Named In Antitrust Lawsuit Alleging Monopoly Scheme, and Proposed Law Would Make Drunk Drivers Pay Child Support

Here is a recap of some of the top industry-related news stories of the week:

Drug companies win in California opioid crisis lawsuit

In a lawsuit where local governments seek billions to cover their costs for the opioid epidemic, a California judge has ruled in favor of top drug manufacturers.

Superior Court Judge Peter Wilson issued a tentative ruling saying there was no proof that pharmaceutical companies used deceptive marketing to increase unnecessary opioid prescriptions and create a public nuisance.

"There is simply no evidence to show that the rise in prescriptions was not the result of the medically appropriate provision of pain medications to patients in need," said Wilson. "Any adverse downstream consequences flowing from medically appropriate prescriptions cannot constitute an actionable public nuisance."

California counties argued the pharmaceutical companies downplayed the risks of addictions, overdoses, deaths and other health complications. They also claimed that the pharmaceutical companies overstated the benefits for long-term health conditions.

The companies had argued "that opioid medications are an appropriate treatment for many chronic-pain patients" and that much of their marketing mimicked approved warnings by the U.S. FDA.

All sides have acknowledged that there is an opioid abuse epidemic.

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Client Alert: MultiPlan Named As Central Figure In Antitrust Lawsuit Alleging Health Insurance Monopoly Scheme

The liquidating bankruptcy trust for Verity Health System of California recently filed a lawsuit in the California Superior Court against third-party “re-pricer” MultiPlan, including its subsidiaries Viant and Data iSight, and more than a dozen of MultiPlan’s customers – including major commercial payers like Anthem, United Healthcare, Aetna, Cigna, and others – alleging antitrust claims under California’s Cartwright Act and Unfair Competition Law.

Verity Health System claims that MultiPlan acted as an unlawful “corporate hub” among the re-pricer and its various insurance company clients, to “fix” the amounts reimbursed to healthcare providers on OON claims. They argue that reductions in reimbursement payments totaled approximately $10 billion per year from 2012 to 2020. This means that profits were increased for MultiPlan’s insurance company clients and for MultiPlan itself.

The complaint alleges that MultiPlan entered into a series of contracts with the various commercial payers, by which MultiPlan was paid to provide the commercial payers with the same artificially deflated payment data, which the commercial payers would all in turn utilize to reimburse their OON healthcare providers at the same reduced rates. According to the complaint, MultiPlan’s commercial insurance customers implemented the identical MultiPlan-set reimbursement rates nearly all the time, and due to MultiPlan’s dominance in the industry, providers have appealed only about 5% of the MultiPlan rates since 2011. The complaint claims that healthcare providers “have no choice but to accept those prices (…) as resistance would be futile.”

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Proposed Missouri law would make drunken drivers pay child support if parent is killed in accident

Cecilia Williams is fighting to propose a law that would make drunk drivers pay child support when they are responsible for the death of a parent, after she was left to care for her son’s two children.

"Bentley's Law" would make drunken drivers responsible for paying child support to a surviving spouse or relative raising children until they are 18.

Williams began working on the law after her son, his fiance, one of their children were killed by a drunk driver whose blood alcohol was twice the legal limit.

“A lot of people find themselves in the position where the person who killed or injured their family, they don’t have insurance, they don’t have assets, they have nothing,” said Williams. “And yet, they somehow have enough to buy other things. … In Bentley’s Law, it would be a part of victim services and will prevent people from having to go through an attorney to get restitution.”

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