Ohio Attorney General Dave Yost has filed a lawsuit in a state court in Ohio against OptumRX in an effort to recover what he alleged were overcharges to the state for the cost of prescription drugs negotiated by pharmacy benefit managers (“PBMs”).
The attorney general's office informed OptumRx on February 11 that the Ohio Bureau of Workers' Compensation (“BWC”) and the state were filing a demand for mediation of disputes. OptumRx had 30 days to respond to the mediation request. That 30-day clock ran out.
“It's been 30 days and we only just now have a meeting scheduled to talk,” Attorney General Yost said in a statement. “Times up, give us our money.”
PBMs are private companies that contract with state agencies such as the BWC and Medicaid to manage drug prescriptions for clients of the agencies.
The state's complaint alleged that OptumRx overcharged the fund intended to protect injured workers by nearly $16 million. The complaint alleged that the overcharges occurred because OptumRx failed to provide contractually agreed discounts on drugs.
“Our review of PBM practices throughout state government is still ongoing,” Attorney General Yost added. “These are the first raindrops, but there's a storm a-comin'.”
The complaint charged that OptumRx overcharged BWC for generic drugs purchased between January 1, 2015 and October 27, 2018 by $15,843,112. Pursuant to BWC's contract, an arbitration demand letter was issued to the American Arbitration Association.
The BWC's contract with OptumRx expired in October, and the BWC has contracted with a different PBM. PBM practices in Ohio and other states have been under intense scrutiny after revelations that some PBMs had been charging states far more for drug prescriptions than the PBMs were paying pharmacists to fill the prescriptions.
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Steven A. Meyerowitz
Steven A. Meyerowitz, a Harvard Law School graduate, is the founder and president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. He may be contacted at [email protected].