United Healthcare’s OptumRx Accused of Defrauding Benefit Plan

OptumRx, the pharmacy benefit manager owned by United Health Group, the nation’s largest health insurer, is being sued over allegations that it wasted tens of millions of dollars of a union benefit plan’s money when acting as the plan’s PBM.

The complaint, filed Aug. 24 in California Superior Court, alleges that OptumRx breached its contract with an employee benefit plan, paying out for fraudulent and illegitimate claims that were supposed to be excluded under the plan.

OptumRx failed to stop the payment of fraudulent and illegitimate claims in order to reimburse for as many claims as possible and profit off ...