NewsGovernmentState GovernmentOhio State Government News


Ohio Attorney General Dave Yost sues OptumRx over $16M in alleged prescription drug overcharges

Posted at 11:16 AM, Mar 18, 2019
and last updated 2019-03-19 01:12:24-04

CINCINNATI — New Ohio Attorney General Dave Yost called it the first raindrops in a coming storm.

WCPO spoke with Yost about a lawsuit his office filed Friday against a pharmacy benefits manager (PBM), OptumRx.

Yost and his team say the PBM overcharged the state for the cost of prescription drugs. According to Yost, investigators found nearly $16 million worth of overcharges to the Ohio Bureau of Workers' Compensation.

“I want my money back,” Yost told WCPO.

PBMs are the middle men companies that manage drug prescriptions for clients.

“What we think is they were playing the float,” Yost said of OptumRx. “A contract says that if they get savings, they have to pass it on to us at BWC, which serves injured workers. We think that they were delaying - just delaying, not failing to do it. They would wait a month or two or three, and when you multiply that by hundreds of thousands of millions of scripts, the numbers can add up pretty quick.”

So Yost sent a letter to OptumRx last month demanding mediation of the financial dispute. The parties have a meeting Wednesday, but now there's the lawsuit to discuss.

“I think action at the state level has a potential to change the way PBMs behave in all their conduct ... to be more fair ... to be more transparent ...,” Yost said. “After all, government is one of the biggest customers . . . I’m hopeful we can get to a better, fairer place.”

WCPO reached out to OptumRx and left a message. We also waited on hold with its parent company with no success.