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Paying for prescription drugs has become a big problem for many Americans as well as for legislators. Legislation designed to control the costs of prescription drugs often stalls in the Legislature. For instance, after Sen. Sara Howard introduced LB862, the Prescription Drug Cost Transparency Act, the bill stalled in committee. Therefore, this week I want to expose what the pharmaceutical companies do to raise the costs of your prescription drugs and what you can do about it.
It may be cheaper for you to pay for your prescription drugs out of pocket than to pay your health insurance company’s co-pay. A recent study conducted by the University of Southern California’s Schaeffer Center for Health Policy & Economics found that customers overpaid for their prescription drugs 23 percent of the time.
The practice of charging copays which are higher than the actual cost of prescription drugs is called a “clawback”. Middlemen who process prescription drug claims for health insurance companies oftentimes make it a practice to claw back extra money from their insured clients when they check out at the pharmacy. For instance, if your co-pay is $10, but the actual cost of your prescription drug is only $7, then you are essentially giving an extra $3 to your health insurance provider.
It does not seem to matter whether or not states have passed anti-clawback laws. Health insurance companies have found ways to get around these kinds of state laws. For instance, some insurance plans prohibit pharmacists from volunteering information about getting cheaper prescription drugs. Therefore, the burden falls upon the consumer to ask the pharmacist if there is a cheaper way to pay for the drug. Six states have passed anti-gag laws to prevent insurance companies from gagging their pharmacists in this way, but Nebraska is not one of these six states.
According to Sydney Lupkin of Kaiser Health News, the top 20 prescription drugs with clawbacks are these: Hydrocodone acetaminophen, levothyroxine sodium, azithromycin, Lisinopril, fluticasone propionate, simvastin, atorvastatin calcium, omeprazole, amoxicillin, amlopidine besylate, sertraline hydrochloride, amox trihydrate/potassium clavulanate, zolpidem tartrate, Ventolin HFA (albuterol sulfate), Crestor (rosuvastatin calcium), metformin hydrochloride, hydrochlorothiazide, metoprolol cuccinate, citalopram hydrobromide, and prednisone.
If you are using any of these prescription drugs, it may be cheaper for you to pay for your prescription drugs out of pocket than to pay your insurance company’s co-pay. The only way to know if you are over-paying is to ask your pharmacist.
On another note, Nebraska State Treasurer, Don Stenberg, has released his 2018 edition of the Unclaimed Property Report. The Nebraska State Treasurer’s office holds more than $170 million in unclaimed money for more than 350,000 current and former Nebraskans. Last year, the Treasurer’s office paid out 16,748 claims totaling $15.3 million. For claims over $500 you will need to mail in a paper claim form. To see if the Treasurer is holding your unclaimed money or to file a claim please go to the State Treasurer’s website at www.treasurer.nebraska.gov or call my office at (402) 471-2616 and my staff will check the list for you.
Finally, although Speaker Scheer’s deadline passed last Friday for the Governor’s property tax relief bill to see another round of debate, he agreed to put LB947 back on the agenda. Without the needed 33 votes, though, LB947 will be dead. So, the petition drive for LB829 represents our best hope for property tax relief this year. Therefore, I want to encourage all of my readers to sign the petition.