UnitedHealth’s OptumHealth Must Remain in Opioid Lawsuits, Judge Rules

Three UnitedHealth Group subsidiaries must remain defendants in federal lawsuits accusing Optum and other companies tied to pharmacy benefit management of contributing to the opioid epidemic, after an Ohio judge rejected their latest effort to leave the cases.

U.S. District Judge Dan Aaron Polster ruled October 15 that OptumHealth Care Solutions LLC, OptumHealth Holdings LLC and Optum Health Networks Inc. can be required to defend federal racketeering and related state-law claims in Ohio. The decision keeps the companies in two bellwether cases within the sprawling National Prescription Opiate Litigation.

The ruling does not determine that the OptumHealth companies contributed to opioid misuse or are liable for any resulting harm. It resolves a procedural dispute over whether the companies can be required to defend the allegations in the federal multidistrict litigation pending before Polster.

The litigation has brought thousands of opioid-related claims into one federal court, with lawsuits over the roles played by drug manufacturers, distributors, pharmacies and other businesses across the prescription-drug system. More recent claims have focused on pharmacy benefit managers, or PBMs, and affiliated companies.

PBMs occupy an influential position between health insurers, pharmaceutical manufacturers and pharmacies. They administer prescription benefits, negotiate drug prices and manufacturer rebates, and help determine which medications receive preferred placement on insurance formularies.

Plaintiffs in the opioid litigation allege that PBMs and related businesses used their position in the prescription-drug system in ways that helped increase opioid prescribing, distribution and sales. The companies dispute the allegations, which have not been proven in court.

The three OptumHealth businesses involved in Polster’s latest ruling are part of UnitedHealth’s broader Optum healthcare-services operation rather than OptumRx, the company’s pharmacy benefit manager. OptumRx is separately involved in the opioid litigation and had already accepted the Ohio court’s jurisdiction.

The latest dispute centered on whether the Ohio court also has authority over the three OptumHealth companies, which are based outside the state.

The subsidiaries relied on the Sixth Circuit’s June 16 decision in Hall v. Trivest Partners. In that case, the federal appeals court ruled that convenience alone was not enough to force several Florida companies to defend a RICO lawsuit in Michigan when they lacked the usual legal connections to the state.

Polster found the opioid cases materially different. The Optum-related defendants are located across several states, and he concluded that there is no single alternative court that could exercise traditional jurisdiction over all of the companies accused of participating in the alleged opioid scheme.

Federal RICO law allows courts in certain circumstances to bring defendants from different states into one proceeding when the “ends of justice” require it. Polster concluded that standard was met because the litigation involves an alleged nationwide conspiracy and no single alternative forum could hear the claims against all of the relevant defendants together.

The judge also rejected the OptumHealth companies’ argument that the complaints improperly treated separate UnitedHealth and Optum affiliates as though they were one business. At this stage of the cases, Polster found sufficient allegations connecting the three subsidiaries to the broader conduct described by the plaintiffs.

His October 15 order also keeps related state-law claims against the companies in the Ohio proceeding because those allegations arise from the same underlying conduct as the federal RICO claims.

The three companies had previously been reinstated in two bellwether cases. Bellwether cases are selected in large multidistrict litigation to test evidence and legal theories and to provide the parties with information about how similar lawsuits could unfold. Their results do not automatically decide other cases, but they can influence litigation and settlement strategies.

The October 15 ruling comes less than two weeks after the Sixth Circuit issued a separate decision limiting efforts to add PBM claims across hundreds of opioid lawsuits.

On October 2, the appeals court ruled that roughly 800 plaintiffs could not automatically add new claims against pharmacy benefit managers years after an earlier deadline without an individualized review of whether each plaintiff had acted diligently. The Sixth Circuit concluded that the district court had gone too far by allowing the late amendments across hundreds of cases at once.

That decision addressed when additional PBM claims could be added to the multidistrict litigation. It did not decide the separate question Polster considered on October 15: whether the three OptumHealth companies can remain defendants in the existing bellwether proceedings.

Polster’s latest decision leaves the claims against the UnitedHealth subsidiaries alive but unresolved. Plaintiffs will still have to prove that the companies participated in conduct that contributed to the opioid crisis, while the OptumHealth defendants retain the ability to challenge those allegations as the bellwether cases move forward.