OptumRx to pay $20M to resolve claims it violated the Controlled Substances Act 

OptumRx, Optum’s pharmacy benefit management company, has agreed to pay $20 million to settle allegations it improperly filled certain opioid prescriptions, violating the Controlled Substances Act.

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From April 2013 to April 2015, OptumRx allegedly filled opioid prescriptions in dangerous combinations with other drugs including benzodiazepines and muscle relaxants, according to a June 27 news release from the Justice Department. 

The department alleges OptumRx filled these prescriptions primarily from a mail order pharmacy location in California, indicating they may not have been intended for legitimate medical use. 

According to the release, these prescriptions carry significant risk of harm and red flags must be resolved prior to filing. OptumRx, however, allegedly received numerous prescriptions that raised red flags but filled those prescriptions without always resolving them. 

Since 2017, OptumRx has reportedly instituted enhanced protocols for opioid prescription and more robust drug utilization review processes. Additionally, OptumRx closed its mail order pharmacy operations at the California location. 

Becker’s has reached out to Optum and will update if more information becomes available.

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