PBMs and their DC lobby group have filed 11 major, high-stakes lawsuits seeking to block or invalidate state reform measures. When lawmakers attempt transparency in drug pricing, PBMs take them to court.

Federal lawsuits have been filed by three hospitals, alleging that CVS and its affiliates (PBMs) ran a sophisticated, coordinated scheme to covertly pocket nearly $250 million in 340B drug savings between 2020 and 2025. www.realclearhealth.com/articles/202...

When the same companies control the insurer, the PBM, the pharmacy, the clinics, the data, and the flow of money, transparency threatens their business models. Big Healthcare didn’t get this big by making care simpler, cheaper, or easier to access.

Three major U.S. hospitals have filed separate federal lawsuits against CVS Health. The complaints allege that CVS and its affiliates engaged in a spread pricing scheme that siphoned approximately $250 million in savings from the federal 340B Drug Pricing Program.

A costly PR campaign run by PBM lobbyists in DC doesn't fix the massive conflict of interest stemming from vertical integration. As long as PBMs own specialty pharmacies and GPOs and manipulate the supply chain, they're running a legalized shell game at the expense of consumers and taxpayers.

🚨Hospitals in Kansas, Michigan, and New York are accusing CVS Health of using its vertically integrated empire to siphon away 340B funds intended for vulnerable patients.

Health insurance companies have the power to deny and delay care through a complex web of subsidiaries that are incentivized to put profits over patients. Big Healthcare has become too powerful.

A year after major health insurance companies claimed they would overhaul prior authorization, the New York Times reports that little has changed.

Despite reform efforts, doctors say prior authorization continues to slow medical care putting patients at risk. https://nyti.ms/4vkwdUP

Meet Big Healthcare's newest revenue strategy: Turning every step of the prescription drug process into a fee-generating opportunity. Vertical integration rewards optimizing revenue streams - not saving consumers money.

Most industries compete on offering a better price, faster service, status, lifestyle, you name it. Not Big Healthcare. They increase revenue by delaying and denying care.

Big Healthcare, like CVS, insists that vertical integration creates "efficiency," but what it really creates is a power imbalance. Now, three major hospitals are suing. They say CVS Health and its subsidiaries used the federal 340B program to siphon hundreds of millions of

Big Healthcare is a staggering $5+ trillion economy, easily dwarfing the total global market values of both Big Oil and Big Tech. Prior authorization is a lucrative financial mechanism for these companies.

Big Healthcare is using the MLR as justification for vertical integration. It's a shell game. 🥥 The parent companies of Aetna, Anthem, Cigna Group, and UnitedHealthcare all own medical clinics, pharmacies, and PBMs, which pay each other.

Health insurance companies have been vertically integrating for over a decade: PBMS • Pharmacies • Doctor Groups • Data Processing • Claims Platforms • Prior Auth Systems • Home Health. They own it all, which is why they get away with ever-higher premiums and deductibles each year.

Big Healthcare is now bigger than Big Oil and Big Tech. The companies controlling your insurance approvals and pharmacy benefits are among the largest corporations in America. Meanwhile, premiums are skyrocketing and deductibles are unrealistic.

Big Healthcare is in an epic battle for survival. Sound on! 🔊

May the Fourth Be With You... as you navigate the healthcare industry. "[PBMs] are the Darth Vader of the pharmaceutical industry." They're supposed to lower drug costs; instead, they're responsible for raising them

New CA report: health plan profits jumped from $399M to $2.9B between 2022–2024 — a 626% increase. Meanwhile, prescription drugs held steady at ~11-12% of the premium dollar over that same period. If you're wondering where premium dollars are going, the data is worth a look.

PBMs were created to negotiate lower drug prices. Today, PBMs are cash cows inside vertically integrated healthcare giants, and cash cows aren't designed to lower prices. The system is broken by design.

"[PBMs] are the Darth Vader of the pharmaceutical industry." They're supposed to lower drug costs; instead, they're responsible for raising them.

Health care costs are high, but no one knows exactly why. What we do know is that normal market forces don't drive down insurance prices because the costs for medical procedures and medicine are negotiated behind closed doors. There's no price transparency by design.

Health insurance companies have become ENORMOUS. And it's driving up healthcare costs because they pay themselves at every step. As @mcuban.bsky.social said in the PBS interview, "they control and set the pricing of all the economics."

Poll from @kff.org: People View Prior Authorization as Greatest Burden in Navigating the Health System ➡️ “Prior authorization review is the poster child for that complexity.” - KFF President and CEO Drew Altman

Kaiser Permanente is the largest health insurance company in California by membership and revenue. It's also a "non-profit" that raked in $9.3 BILLION in profit last year and sits on a $73 BILLION reserve. But all that money doesn't translate to better care or faster service. 😡

61% of Americans worry a great deal about healthcare access and affordability. Meanwhile... Big Health Insurance is raking in money. https://twitter.com/DrewAltman/status/2038995755667431570

The fastest-growing “cost” in health care isn’t medicine. It’s margin. According to the California Dept of Managed Health Care, health plan profits surged from $399 million in 2022 to $2.9 billion in 2024 — a staggering 626% increase in just two years.

Prior authorization isn’t just paperwork. It’s power. In West Virginia, repeated denials of a doctor-recommended cancer treatment delayed care until the patient no longer qualified and died. https://bit.ly/4sB68zf

Prior authorization isn’t just paperwork. It’s power. In West Virginia, repeated denials of a doctor-recommended cancer treatment delayed care until the patient no longer qualified and died. bit.ly/4sB68zf

Kaiser Permanente is the largest health insurance company in California by membership and revenue. It's also a "non-profit" that raked in $9.3 BILLION in profit last year and sits on a $73 BILLION reserve. But all that money doesn't translate to better care or faster service. 😡

Ladies and gentlemen: The Top 10 Signs Your Health Insurance Company is Too Powerful! 🎤🤑

A new lawsuit alleges CVS Caremark inflated the cost of generic drugs, charging patients and employers far more than the actual price. This isn't the first time we've heard this, and it won't be the last. bit.ly/3NSu8zn

CBS News analyzed 1.3 billion health insurance claims and found insurers denied 19% of in-network claims in 2024. That’s nearly 1 in 5 claims rejected. When profits depend on patients using less care, the system stops being about health. It becomes about denial.

Health insurance companies often claim that PBMs help them manage drug costs. But today, many insurers own the PBM directly. That means the company is deciding: • which drugs are covered • which pharmacy you use • how much rebate money flows through the system

Research shows the 340B contract pharmacy market is highly concentrated. A handful of companies—particularly CVS, Walgreens, Walmart, UnitedHealth (Optum), and Cigna (Express Scripts)—control more than 75% of the program's contract pharmacy relationships.

Health insurance companies overriding doctors and their expertise in rare diseases like ALS is literally a life and death matter. (Assemblymember Rick Chavez Zbur speaking about his sister.)

Want proof that 340B is material to corporate revenue? CVS Health’s own 2023 financial report warns investors that profits could suffer if: ✅ Fewer covered entities use contract pharmacies ✅ Fewer entities use CVS administrative services ✅ Drug manufacturers reduce participation

340B was meant to help the poor and vulnerable get access to medication and expand health services. But CVS Health is gaming the system for profit. The system is broken. It's time for transparency.

The 340B Program was designed to provide discounted drugs and charity care to vulnerable patients. CVS Health, the largest contract pharmacy in the 340B program, uses it to make significant profits.

They passed “PBM reform.” Problem solved… right? Not so fast. Health care conglomerates like CVS Health, which owns CVS Pharmacy (retail), Aetna (insurance), CVS Caremark (pharmacy benefit manager), and at least 6 other subsidiaries, have plenty of ways to hide revenue.

For some, the federal 340B program is a genuine healthcare safety net. But for too many giant corporations, such as CVS, it's a slush fund with no accountability to the people it's meant to serve.

Healthcare conglomerates are TOO BIG TO CARE about rising costs for consumers. Vertical integration among insurance companies, PBMs, and mail-order specialty pharmacies is causing a healthcare crisis.

Sales of 340B drugs reached a high of $66 billion in 2023. The latest Cassidy 340B reform report reveals that CVS and Walgreens are charging covered entities rising fees and pocketing a share of federal drug discounts. These mega corporations are profiting at the expense of vulnerable communities.

🚨 House panel finds CVS Caremark may have broken antitrust laws

PBMs like Express Scripts now control the drug supply chain — shaping formularies and steering patients to pharmacies they own. Instead of reducing costs for patients and employers, these mega-corporations are vertically integrating for their own benefit. Transparency is crucial.

Vertical integration lowers costs only when firms compete on price and must share savings. In U.S. health care, consolidation mainly increases leverage — not efficiency. So instead of: 📉 lower prices We get: 📈 higher premiums 📈 higher out-of-pocket costs 📈 record profits

A House committee found that CVS Health might have violated federal antitrust laws by threatening independent pharmacies to prevent them from using outside money-saving services.

The largest contract pharmacies are gaming the 340B program, resulting in a $5.2B increase in healthcare costs for self-insured employers and the 103.4M workers they employ. https://bit.ly/340BShuffle

A House committee found that CVS Health might have violated federal antitrust laws by threatening independent pharmacies to prevent them from using outside money-saving services.

Huh. This is interesting. CVS Health owns Wellpartner - a third-party administrator that processes 340B claims. Their website claims $2+ billion in annual savings. How much you wanna bet that money isn't finding its way to the low-income people it was originally intended to serve?