A Massachusetts woman is suing a Fortune 500 insurance company,claiming that it requires the network of pharmacies with which itcontracts to overcharge insured patients "unauthorized andexcessive amounts" for prescription drugs.

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The suit, filed Oct. 13 by Kimberly Negron in federal court inConnecticut, accuses Bloomfield, Connecticut-based Cigna Corp. andthe company’s Cigna Health and Life Insurance Co. unit of engagingin a racketeering scheme that's led to multiple violations offederal Employee Retirement Income Security Act provisions.

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The suit claims that Cigna or its agents, without customerknowledge, "clawed back" excess charges as high as 1,043 percentfor low-cost, generic prescriptions, according tothe suit. Negron seeks to certify her case as a class action,claiming the alleged overcharge scheme "is pervasive andsignificantly increases the costs to patients across thecountry."

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According to the suit, the illegal overcharges occur "thousandsof times each day in pharmacies all across the country" and areimposed through "a nationwide, clandestine, computerized scheme"that allegedly includes mail and wire fraud.

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The suit contends that Cigna or its agents, among them Optum andArgus Health Systems, which are pharmacy benefit managers notincluded in the litigation, routinely require Cigna networkpharmacies to collect co-payments from Cigna customers even whenCigna contracted to pay far less.

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In one case, Cigna contracted to pay $1.75 per prescription fora well-known blood pressure medication but required its pharmacynetwork to collect $20 co-pays from customers. The $18.25difference, which the suit describes as "the spread," was then sentto Cigna.

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Related: UnitedHealth accused of gouging customers onprescription drugs

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The result is "a hidden payment" to the insurance company,according to the suit. But under confidentiality provisionsincluded in agreements between the pharmacy benefits managers andthe network pharmacies, the pharmacies cannot tell insuredcustomers they're being overcharged or that the drugs can beobtained more cheaply, the suit contents.

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Claw backs were imposed most frequently on widely used, low-costgeneric drugs, according to the suit. "It enables the defendants toimpose deductible costs, co-payments and co-insurance costs thatare higher than the cost of the drug," according to the suit.

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The proposed class would include anyone insured by Cigna whobought prescription drugs and paid fees that were higher than Cignacontracted to pay.

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A Cigna spokeswoman declined to comment on the suit.

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West Hartford attorney Robert Izard of Izard, Kindall &Raabe, whose firm is representing Negron, said Monday that thealleged overcharge scheme has been in place for at least threeyears. The firm partnered with Great Neck, New York, firm SarrafGentile in the case.

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The suit asks for actual as well as treble damages under theRacketeer Influenced and Corrupt Organizations Act, but Izard saidit's difficult to calculate the amount of money Cigna may havecollected. "I don't know how many prescriptions are written underCigna policies every year," he said. "It's hard to put a dollarfigure on [it]."

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R. Robin McDonald

Daily Report reporter R. Robin McDonald's journalism career includes stints as a staff writer at The Atlanta Journal-Constitution, The Fort Worth Star-Telegram, The Wichita Eagle, and The Anniston Star and as a trial tracker at CourtTV and CNN. She is the author of two true crime books -- Black Widow: The True Story of the Hilley Poisonings and Secrets Never Lie: The Death of Sara Tokars.