Pharmacy benefits manager OptumRx Administrative Services LLC has denied allegations in a lawsuit filed in 2019 by the Ohio Bureau of Workers Compensation claiming the company overseeing prescriptions for injured workers in the state overcharged, according to legal documents made public this week. 

Denying allegations that it “promised savings” to the state, among other claims Optum made in its 13-page defense dated Dec. 31, 2019, the pharmacy benefits manager is in turn accusing the state of “unilaterally” amending state provisions related to reimbursement rates in the “midst of the parties’ contractual term.”  

Ohio Attorney General Dave Yost, representing the BWC, amended the original March 2019 complaint in November 2019, bringing additional claims and damages, claiming breach of contract allegations and adding more detail to overcharges for specific drugs.

The original lawsuit filed in March in the Court of Common Pleas in Franklin County, Ohio,  claimed the PBM overcharged the BWC nearly $16 million for generic drugs purchased between Jan. 1, 2015, and Oct. 27, 2018, according to that complaint that alleges “BWC was regularly charged commercially unreasonable prices for generic drugs.” 

The BWC’s contract with OptumRx expired in October 2018, according to the state.

Decisions on motions to dismiss the claims and award the PBM damages not limited to attorneys’ fees are scheduled for Feb. 18.

Neither BWC nor Optum would comment on the suit.

Meanwhile, Missouri lawmakers proposed legislation Wednesday aiming to regulate PBMs operating in the state.

H.B. 1973 would require all PBMs to maintain a valid license for a fee not to exceed $500 to be renewed on a biennial basis. The bill also mandates that PBMs provide to the Missouri Department of Insurance copies of their corporate charter, licensure, the names and contact information of employees who will serve as contacts for the department and additional information. If signed into law, it would take effect Jan. 1, 2021.