OptumRx Now at Risk of $1 Billion in Claims From Pharmacies

UnitedHealth Group’s OptumRx Inc. suffered a legal defeat reopening the pharmacy benefit manager to potential liability from hundreds of independent pharmacies.

About $1 billion in claims against the pharmacy benefit manager could reach open court, as California’s Fourth District Court of Appeal ruled July 12 that Optum unilaterally and unlawfully amended its arbitration agreement with the pharmacies with terms seeking to enforce company-favoring provisions retroactively.

“A contract that permits one party an unfettered, unilateral right to modify a contract is an illusory contract that is not enforceable,” Justice Maurice Sanchez wrote in the unpublished opinion.

The pharmacies seek to ...