UnitedHealth Group is working to avoid a major class-action lawsuit from around 1,000 independent pharmacies nationwide for alleged under-reimbursements totaling more than $100 million, according to Bloomberg.
Last week, Optum Rx, UnitedHealth's pharmacy benefits manager, filed over 200 cases in California federal court to force individual arbitration instead of a joint lawsuit.
About 500 of the small pharmacies are involved in the current dispute, while the rest have filed cases in other courts.
The pharmacies claim Optum Rx under-reimbursed them and reversed payments. They also say Optum Rx occasionally considered prescriptions as brand-name when working with payers but considered the same medications as low-cost generics when reimbursing pharmacies. The disputed payments total in excess of $100 million for nearly a decade, though no pharmacy has filed any litigation yet.
"They want each of these pharmacies to have a separate arbitration, 500 separate arbitrations," the pharmacies' attorney, Mark Cuker, told Bloomberg. Optum Rx is "gaming the system," Mr. Cuker said.
Optum Rx first received notice of the dispute in December. It said Mr. Cuker would only come to a resolution in court, according to Bloomberg.
"Optum Rx is focused on delivering affordable access to prescription drugs," an Optum Rx spokesperson told Bloomberg. "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."