Ohio AG seeks $16M repayment from Optum for drug overcharges

FierceHealthcare | February 20, 2019

Ohio’s attorney general is seeking to claw back nearly $16 million in funds he says Optum overcharged a state agency for drugs. In a letter (PDF) to OptumRx last week, AG Dave Yost says OptumRx, the company’s pharmacy benefit manager arm, failed to pass on discounts to the state’s Bureau of Workers’ Compensation on multiple occasions between 2015 and 2018, totaling $15.8 million in pharmacy overcharges. Yost said in a statement that the PBMs deal with the bureau requires formal mediation before the state can sue—an option that he signaled is on the table. “I hope that OptumRx will refund these overcharges,” Yost said. “I am investigating PBM practices on behalf of a number of state clients and will not hesitate to pursue overcharges and fraudulent conduct. This is an important first step in this process.”

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In 2020 the world changed as we know it. The COVID-19 pandemic brought into sharp focus the vulnerabilities that exist in many healthcare systems. Healthcare providers had to quickly adapt their service delivery models, consider future possible scenarios, and continue to innovate.


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Spotlight

In 2020 the world changed as we know it. The COVID-19 pandemic brought into sharp focus the vulnerabilities that exist in many healthcare systems. Healthcare providers had to quickly adapt their service delivery models, consider future possible scenarios, and continue to innovate.

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