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Ohio, OptumRx disputes whether settlement was reached



Ohio Attorney General Dave Yost on Tuesday announced a settlement with OptumRx that requires the pharmacy benefits manager to repay the state $15 million in prescription drug overages determined to the Ohio Bureau of Workers’ Compensation.

Still, a spokesman for the Irvine, Calif.-based company, which disputes the allegations, said a settlement had not been reached.

“We continue to dispute his allegations and are honored to have provided access to more affordable prescription medications for the Ohio Bureau of Workers’ Compensation and Ohio taxpayers,” the spokesman wrote in an email to Business insurance.

Yost’s office did not respond to requests for comment.

The state̵

7;s lawsuit against OptumRx alleges the company overbilled the agency $15.8 million between 2015 and 2018; it claims the company failed to manage generic drug costs in accordance with contractually 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 failing to achieve a target reimbursement rate for certain pharmacy claims during a two-year contract extension.


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