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TexasTowelie

(116,554 posts)
Mon Dec 28, 2020, 02:49 AM Dec 2020

Ohio Attorney General Dave Yost says email shows OptumRx was overcharging the state - and knew it

Ohio Attorney General Dave Yost's office says it may have uncovered evidence in a court battle to show that a pharmacy benefit manager knowingly overcharged a state agency.

Among hundreds of thousands of emails obtained from PBM OptumRX as part of the litigation was one that appears to acknowledge that the multibillion-dollar corporation was not following the terms of its contract with the Ohio Bureau of Workers' Compensation.

Starting with its predecessor, a company called Catamaran that OptumRX acquired, the PBM administered prescription drugs for workers injured on the job. In all, OptumRX overcharged the bureau on more than 1.3 million claims for generic medications, the lawsuit says.

The contract, in effect from mid-2009 until the fall of 2018, called for the PBM to charge the lowest of four potential prices for generic drugs, including a measure from the Centers for Medicare and Medicaid known as the Federal Upper Limit, or FUL for short.

Read more: https://www.beaconjournal.com/story/news/healthcare/2020/12/27/ohio-dave-yost-says-pbm-optumrx-overcharges-shown-email-bureau-of-workers-compensation-suit/4028221001/

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