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An independent Iowa pharmacy has filed a class-action lawsuit against UnitedHealth Group and Optum Rx, its pharmacy benefit manager, for allegedly pressuring pharmacies to agree to "unconscionable" performance-based fees.
These direct remuneration fees, or DIR, allow PBMs to retroactively adjust how much pharmacies are reimbursed based on their quality performance. In the lawsuit, Osterhaus Pharmacy said OptumRx forces pharmacies to accept one-sided contracts or lose access to millions of potential customers with pharmacy benefits through the PBM.
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