Of Carelon and Care-less: The Sloppy Scam of Elevance Health's PBM
Or, an open letter to my readers who work there, and I know that because they subscribed with corporate emails.
“I’m Owen…and this is crazy, but I just called you, and you provided the number of the CarelonRx specialty pharmacy as a resolution rep, so please don’t drop my call, maybe?
I am a writer, and doctor, and people sometimes get upset when I call out Big Health.
One of the things I take issue with is when, as a patient, I suffer the same indignity my patients routinely experience in the scam-o-rama that is US health care. I can report on it when it’s me without violating anyone’s privacy but my own, you see.
I have psoriatic arthritis. I’ve written about that before. I take a medicine called Taltz1. It only works so well, and it’s a specialty drug. I’m on the insurance of my spouse, and they have chosen to get a Blue Cross Plan. They have made my life difficult. They have done things that are a problem2 for me. But they are more of a problem for the employers who purchase their “coverage!”
Blue Cross is a trusted brand in American Health care. Blue Cross, in many places, is part of Anthem. Anthem isn’t Anthem anymore. It has been rebranded, to Elevance Health3. This is, in theory, “insurance.” It’s also Carelon, and was Beacon, and ValueOptions, and who knows what else.
It is a criminal syndicate. And the devilishly awful news? is that everyone who buys this poisonous product for their company is also committing a crime too—it's an ERISA4 fiduciary breech!
Yes, I am serious. No, you aren’t covered by your directors and officers’ insurance. Go check. I’ll wait.
1 frantic hour later…
Yes. That call with legal was expensive. Remember when the software industry used dissatisfaction among employees as their enforcement mechanism? Like all companies who were pirating software could be turned in by grump employees for millions in files?
This is that. But with TAX EVASION5.
Employee benefits6 are tax exempt7 because of laws almost everyone is in violation of…the lawsuits are already flying.
Hammer v. Johnson Senior Ctr., 2020 WL 7029160 (W.D. Va. 20208)
No. No hyperlink9. It’s part of the process…Does your PBM used Cost Plus Pricing, for example? You don't even know what those words mean (on average).
I could make it easy for you—link to examples, resources, etc. But your plan doesn’t do that either. Which is the meta point I am making. It is not very nice. It is serious, however.
It’s expensive.
No, no link.
No link. It’s just an empty promise of a footnote.
You know how google works?
Tax evasion is a crime.
Benefits. For employees.
They don’t pay taxes on those benefits.
It’s a court case.
I’m noticing this isn’t helpful?