Ohio Attorney General Dave Yost on Tuesday announced a settlement with OptumRx that calls for the pharmacy benefits manager to repay the state $15 million in prescription drug overcharges determined to the Ohio Bureau of Workers’ Compensation.
The state’s lawsuit against OptumRx alleged that the Irvine, Calif.-based company overbilled BWC, which provides workers’ compensation insurance for employers in the state, $15.8 million from 2015 through most of 2018, and alleged that the company failed to manage the costs of generic drugs ii in accordance with agreed discounts for injured workers.
In November 2019, the state filed an amended complaint alleging that OptumRx breached its contract by applying an incorrect reimbursement rate to certain generic drug claims and by failing to achieve a target reimbursement rate for certain pharmacy claims during the final two-year contract extension.
According to Yost̵7;s office, OptumRx denied the allegations and, according to the settlement agreement, OptumRx admits no wrongdoing or liability. Company officials could not be reached for comment.