Independent pharmacies sue major PBM over alleged illegal price discrimination and reimbursement violations

Pharmacists United for Truth and Transparency

15 May 2020 - The newest litigation against a major pharmacy benefit manager comes from a likely source: its small business victims. 

More than 50 independent pharmacies have filed a class action lawsuit against OptumRx, a division of UnitedHealth Group, after the company's failure to comply with state pharmacy claims reimbursement law.

The lawsuit alleges OptumRx acted unlawfully by ignoring state legal requirements, paying local pharmacies substantially less than it paid large chain retail pharmacies like CVS or Walgreens and far below what it paid its own mail order pharmacy for the same prescriptions. The lawsuit further alleges OptumRx often knowingly reimbursed local pharmacies below wholesale cost to stock necessary generic prescription drugs.

Read Pharmacists United for Truth and Transparency press release

Michael Wonder

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Michael Wonder

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US , Regulation , Health plans