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District Court Dismisses Class Action Challenge to UnitedHealth PBM Payments (PDF)
U.S. District Court for the District of Minnesota 
Dec. 20, 2017
36 pages. "Plaintiffs allege ... that they were entitled to pay less than they were charged as copayments or coinsurance under the terms of their plans because their plans entitled Plaintiffs to receive the benefit of the discounted rate ... Plaintiffs allege that they purchased certain drugs on numerous occasions and were overcharged due to OptumRx's contribution calculations, resulting in spreads and clawbacks.... [The plans] do not entitle those ERISA Plaintiffs to the discounted rate as a 'lesser of' payment option when filling prescription drugs at retail network pharmacies. Because those ERISA Plaintiffs do not allege that Defendants violated the terms of their Plans other than by not allowing them to pay lesser, discounted rates, such Plaintiffs fail to state claims for benefits under ERISA Section
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