Express Scripts Unable to Dodge NYC Transit Agency Contract Suit

Express Scripts Inc. lost a bid to end a New York City Transit Authority suit claiming that it breached their contract by failing to detect and report allegedly fraudulent compound drug prescriptions, a federal court in New York said.

The pharmacy benefits manager’s contractual due diligence requirement for processing claims and monitoring pharmacies could be interpreted as including a duty to detect fraud, which ESI allegedly breached, the U.S. District Court for the Southern District of New York said.

At the least, the contract language provides a reasonable basis for concluding that ESI was expected to actively monitor and investigate ...