COLUMBUS – The state is taking the first steps toward recovering nearly $16 million it claims the Bureau of Workers’ Compensation was overcharged by pharmacy benefit managers for the cost of prescription drugs.
Pharmacy benefit managers, known as PBM’s, are private companies that contract with state agencies to manage drug prescriptions for clients and Attorney General Dave Yost charges that OptumRx overcharged the BWC to the tune of $15.8 million for generic drugs purchased between Jan. 1, 2015, and Oct. 27 of last year, Yost said in a release from his office.
Yost has informed OptumRx that state and the bureau intend to file a demand for mediation of disputes with the American Arbitration Association over the overcharges, which Yost says occurred because OptumRx failed to provide contractually agreed discounts on drugs.
The agency’s contract with the company requires the state to try to settle the dispute through mediation before filing a lawsuit.
“I hope that OptumRx will refund these overcharges. 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,” Yost said.
Yost says he and Gov. Mike DeWine continue to review PBM practices to determine if the state was overcharged for drugs purchased by other state agencies. Yost has hired outside counsel and experts to evaluate PBM data and pursue litigation if necessary.
The bureau’s contract with OptumRx expired in October and the agency has since contracted with a different PBM.