Ohio Attorney General Dave Yost filed an updated complaint Nov. 22 against OptumRx, the former pharmacy benefit manager for the state's Bureau of Workers' Compensation, claiming it breached its contract by not fulfilling its obligation to give the state the best available rates, according to The Columbus Dispatch.
Mr. Yost originally filed a lawsuit against OptumRx in March 2019 to recoup $16 million in alleged overcharges. After months of mediation have failed to resolve the dispute, the attorney general's office filed the updated complaint.
The new court filing says the worker's compensation bureau "suffered significant financial damages in the form of overpayments for generic drugs dispensed to BWC claimants," according to The Columbus Dispatch. It also alleges OptumRx overcharged Ohio so it could offer its other clients lower rates.
Ohio's Bureau of Workers' Compensation is the largest state-run insurance system in the U.S. and spends about $86 million a year on prescription drugs.
The complaint claims OptumRx charged the agency as much as six times the allowed maximum rate in the contract. It says it charged 204 percent of the maximum rate for tramadol, an opioid analgesic, and 619 percent of the maximum rate for baclofen, a muscle relaxer. Even a common painkiller, ibuprofen, was priced at 177 percent the maximum rate, according to the lawsuit.
The Ohio lawsuit seeks a fine of up to $5,000 for each day the excessive prices were charged. The fine alone could result in a payment to the state of as much as $20 million. Ohio had a contract with OptumRx from 2009 until it expired in October 2018 and the state declined to renew it.
More damages could be assessed in other areas of the lawsuit.
"We are honored to have delivered access to more affordable prescription medications for the Ohio Bureau of Workers’ Compensation and Ohio taxpayers. We believe these allegations are without merit and will vigorously defend ourselves," OptumRx claimed in a statement to The Columbus Dispatch.
Read the full article here.
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