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Business
Legal


UNITEDHEALTH TRIES TO STOP LAWSUITS FROM MOM-AND-POP DRUGSTORES

 * The dispute is over more than $100 million in drug payments
 * Pharmacies say Optum Rx unit has underpaid them for years

   

Photographer: Bill Oxford/iStockphoto/Getty Images

By

John Tozzi

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April 1, 2022, 12:36 PM GMT


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Hundreds of small, independent drugstores are accusing UnitedHealth Group Inc.
of short-changing them by more than $100 million, and the health-care giant is
trying to head off a lawsuit before it goes to court.

UnitedHealth’s Optum Rx unit filed more than 200 legal cases this week in
federal court in California to force the cases into individual arbitration
processes, rather than allow a joint lawsuit to go forward, according to legal
filings.




At least 1,000 independent U.S. pharmacies are challenging payment practices at
Optum Rx, UnitedHealth’s pharmacy benefits management unit that negotiates drug
prices for health plans and companies, according to Mark Cuker, a lawyer
representing the drugstores. About 500 are involved in the current dispute,
while others have already filed cases in different courts. Making each of them
enter arbitration is costly and limits the information they could gather through
discovery, Cuker said.



“They want each of these pharmacies to have a separate arbitration, 500 separate
arbitrations,” even though the pharmacies are raising common issues, Cuker said.
Optum Rx is “gaming the system,” he said.



State courts have rejected other attempts to compel private arbitration over
similar claims he’s brought against Optum Rx, Cuker said. 



“Optum Rx is focused on delivering affordable access to prescription drugs,” the
company said in a statement. “The more than 67,000 retail pharmacies in Optum
Rx’s networks are important partners in these efforts, and we continue to work
with them to balance the need to fairly compensate pharmacies while managing
costs.”

The pharmacies involved in the cases say Optum Rx reimbursed them less than
required and clawed back payments, according to UnitedHealth’s filings. They
also said Optum Rx sometimes called medications brand-named drugs when dealing
with health plans but considered the same medicines lower-cost generics when
paying pharmacies. Cuker estimated the total value of payments from Optum Rx
that his clients are disputing exceeds $100 million over almost a decade.

Optum Rx received notice of the dispute from more than 500 pharmacies in
December and said that the pharmacies’ lawyer would only resolve the dispute in
court. The pharmacies have not yet filed litigation against Optum Rx.





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