读者文摘:你不知道的医药多余消费(3)

CVS Caremark and Express Scripts Holding Co. have claimed that they don't use clawbacks,

西维斯公司和快捷药方公司声称，他们没有回扣行为，

but in a lawsuit¹ filed against CVS Health Corp., plaintiff Megan Schultz stated that the practice was part of both PBMs' agreements with CVS pharmacies².

但在一起针对CVS Health Corp.的诉讼中，原告梅根·舒尔茨表示，药品利益管理机构与西维斯药店协议里有这方面的内容。

Many plans require pharmacists to collect payment when prescriptions³ are filled and prohibit them from waiving⁴ or reducing the amount.

协议规定，药剂师在配药时收取费用，并严禁他们放弃或减少费用。

Pharmacies who contract with -OptumRx, for instance, could be terminated for "actions detrimental⁵ to the provider network,"

例如，根据2016年药品福利管理公司的提供者手册，药店若有任何“有损于医疗护理提供者网络”的行为

doing anything that "disparages⁶" it, or trying to "steer⁷" customers to other coverage⁸ or discounted plans, according to OptumRx's 2016 provider manual.

做任何“贬低”，或者试图“引导”客户转向其它保险或折扣计划，其与药品福利管理公司的合约就会被终止。

"They're usually take-it-or-leave-it contracts," says Mel Brodsky, Executive Director of the Philadelphia Association of Retail⁹ Druggists.

费城零售药店协会的执行董事梅尔·布罗斯基表示：“他们通常有两个选择，要么接受要么放弃。”

Independent pharmacies in particular fear getting removed from re-imbursement networks, a potential death blow in smaller communities.

独立药店尤其害怕从医疗护理提供者网络中移除，这对较小的社区来说是一个潜在的致命打击。

A survey of 640 independent community pharmacists by the National Community Pharmacists Association found that 83 percent of the respondents see at least ten clawbacks a month.

美国国家社区药剂师协对640名独立社区药剂师的调查发现，83%的受访者每个月至少会收到10笔回扣。

"I've got three drugstores, so I see a lot of it," David Spence, a Houston pharmacist, says.

“我和三家药店合作过，所以我了解，”休斯顿药剂师大卫·斯宾塞说道。

"We look at it as theft—a way for the PBMs to steal."

“我们认为药品利益管理机构的做法属于偷窃行为。”

Many legislatures are responding.

许多立法机构正在作出回应。

At least 13 states have enacted¹⁰ laws prohibiting "gag clauses" that prevent pharmacists from telling customers about clawbacks;

至少有13个州颁布了禁止言论条款，药剂师不允许向顾客透露有关药品回扣的信息；

at least 22 additional states have similar laws pending¹¹.

至少有22个州也在等待颁布这样的法律。

In the meantime, when customers question their co-pay amounts, some pharmacists jump at the opportunity to explain how they can pay less.

与此同时，当顾客质疑他们的合作付款金额时，一些药剂师趁机向他们解释如何能支付得更少。

"Most don't understand," says Spence. "If their co-pay is high, then they care."

“大多数人都不明白，”斯宾塞说。“如果合作付款数额高的话，人们就会关心。”

1 lawsuit   

n.诉讼，控诉

参考例句：

• They threatened him with a lawsuit.他们以诉讼威逼他。
• He was perpetually involving himself in this long lawsuit.他使自己无休止地卷入这场长时间的诉讼。

2 pharmacies   

药店

参考例句：

• Still, 32 percent of the pharmacies filled the prescriptions. 但仍然有32%的药剂师配发了这两张药方。 来自互联网
• Chinese herbal pharmacies, and traditional massage therapists in the Vancouver telephone book. 中药店，和传统的按摩师在温哥华的电话簿里。 来自互联网

3 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

4 waiving   

v.宣布放弃( waive的现在分词 )；搁置；推迟；放弃（权利、要求等）

参考例句：

• Other steps suggested included waiving late payment charges, making quicker loan decisions and easing loan terms. 其他测试还包括免去滞纳金，尽快做出贷款决定和放宽贷款条件。 来自互联网
• Stuyvesant Town offers the same perk on some apartments, along waiving the broker's fee. StuyvesantTown对于他们出租的某些房子也提供同样的好处，顺带还省略了中介费。 来自互联网

5 detrimental   

adj.损害的，造成伤害的

参考例句：

• We know that heat treatment is detrimental to milk.我们知道加热对牛奶是不利的。
• He wouldn't accept that smoking was detrimental to health.他不相信吸烟有害健康。

6 disparages   

v.轻视( disparage的第三人称单数 )；贬低；批评；非难

参考例句：

• A prudent traveller never disparages his own country. 聪明的旅行者从不贬低自己的国家。 来自《简明英汉词典》
• She often aggrandises herself and disparages her colleagues. 她经常吹嘘自己而贬低同事。 来自《简明英汉词典》

7 steer   

vt.驾驶，为…操舵；引导；vi.驾驶

参考例句：

• If you push the car, I'll steer it.如果你来推车，我就来驾车。
• It's no use trying to steer the boy into a course of action that suits you.想说服这孩子按你的方式行事是徒劳的。

8 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

9 retail   

v./n.零售；adv.以零售价格

参考例句：

• In this shop they retail tobacco and sweets.这家铺子零售香烟和糖果。
• These shoes retail at 10 yuan a pair.这些鞋子零卖10元一双。

10 enacted   

制定（法律），通过（法案）( enact的过去式和过去分词 )

参考例句：

• legislation enacted by parliament 由议会通过的法律
• Outside in the little lobby another scene was begin enacted. 外面的小休息室里又是另一番景象。 来自英汉文学 - 嘉莉妹妹

11 pending   

prep.直到，等待…期间；adj.待定的；迫近的

参考例句：

• The lawsuit is still pending in the state court.这案子仍在州法庭等待定夺。
• He knew my examination was pending.他知道我就要考试了。