DOJ fines OptumRx $20M for opioid prescriptions

OptumRx has reached a settlement agreement to pay $20 million for allegedly violating the Controlled Substances Act by improperly filling certain opioid prescriptions, the Department of Justice recently disclosed. The company faced accusations of inaccurately processing prescriptions for "trinity prescriptions," which include benzodiazepines and other muscle relaxants, from April 2013 to April 2015. These prescriptions, which are known to be addictive, may not have been “intended for legitimate medical use” and pose a “significant risk of harm,” according to the agency's announcement.

Principal Deputy Attorney General Brian Boynton, who leads the Justice Department’s Civil Division, emphasized the responsibility of pharmacies dispensing opioids and other controlled substances. He stated, "Pharmacies providing opioids and other controlled substances have a duty under the Controlled Substances Act to ensure that they fill prescriptions only for legitimate medical purposes." Boynton further mentioned that the department would continue to collaborate with law enforcement agencies to ensure that pharmacies do not exacerbate the opioid crisis.

As a result of these allegations, Optum has shut down its mail-order pharmacy in Carlsbad, California, where the improper prescriptions were reportedly filled. The company has also strengthened its protocols to minimize the number of improperly filled prescriptions, implementing a more rigorous drug utilization review process.

U.S. Attorney Tara McGrath for the Southern District of California highlighted the critical role that pharmacies play in safeguarding the public from potentially dangerous and addictive medications. She stated, "Combating the opioid crisis on all fronts includes holding pharmacies accountable if they shirk any part of the responsibilities required in filling prescriptions for potentially harmful drugs."

Despite the settlement, Optum did not admit to any wrongdoing. The company maintains that it has taken significant steps to address the issues and ensure compliance with regulatory standards.

In a related development, Arkansas filed a lawsuit last month against Optum and Express Scripts, accusing the pharmacy benefit managers of contributing to the opioid epidemic. This lawsuit underscores the increasing scrutiny and legal challenges faced by companies involved in the distribution and management of opioid medications.

This series of legal actions and settlements highlights the ongoing efforts by federal and state authorities to combat the opioid crisis by holding companies accountable for their roles in the distribution of controlled substances. The settlements and lawsuits aim to ensure that pharmacies and other involved parties adhere strictly to the regulations governing the dispensing of potentially harmful medications. As the opioid crisis continues to affect communities across the nation, these measures represent a critical component of a broader strategy to address and mitigate the epidemic.