Online pharmacy’s operations halted over untimely payment of claims, officials say

(Source: WAFB)
Published: Jan. 23, 2023 at 3:45 PM CST
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BATON ROUGE, La. (WAFB) - The Louisiana Department of Insurance has issued cease-and-desist orders to Express Scripts and the Office of Group Benefits.

According to the Louisiana Department of Insurance, both organizations violated state law by failing to pay more than 1.3 million prescription insurance claims in a timely manner.

Express Scripts Administrators is a third-party administrator that operates as a pharmacy benefits manager for the Office of Group Benefits, according to officials with the Louisiana Department of Insurance. They added that the Office of Group Benefits provides health and life insurance benefits to many state employees.

Officials said a market conduct investigation of Express Scripts Administrators got underway in April of 2022 after several complaints were received from the Louisiana Independent Pharmacy Association. The complaints had to do with the handling of claims by Express Scripts Administrators, according to the Louisiana Department of Insurance.

“Louisiana health care providers are deserving of full compliance with Louisiana law relative to payments they are entitled to receive from insurers and the third-party administrators associated with them,” said Louisiana State Insurance Commissioner Jim Donelon.

Officials said Express Scripts Administrators and the Office of Group Benefits have 30 days to request an appeal before the cease-and-desist orders become final.

To read the cease-and-desist orders, click here.

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