Anne Arundel County, Maryland v. Express Scripts, Inc.

CourtDistrict Court, D. Maryland
DecidedJanuary 21, 2025
Docket1:24-cv-00090
StatusUnknown

This text of Anne Arundel County, Maryland v. Express Scripts, Inc. (Anne Arundel County, Maryland v. Express Scripts, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Anne Arundel County, Maryland v. Express Scripts, Inc., (D. Md. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

* ANNE ARUNDEL COUNTY, * MARYLAND, * * Plaintiff, * * Civ. No.: MJM-24-90 v. * * EXPRESS SCRIPTS, INC., et al., * * Defendants. * * * * * * * * * * * *

MEMORANDUM Plaintiff Anne Arundel County (the “County”) brings this action against several pharmacy benefit managers and prescription drug distributors (“Defendants”), alleging one count of public nuisance. Am. Compl. (ECF No. 55). Defendants include Express Scripts, Inc.; Express Scripts Administrators, LLC; Medco Health Solutions, Inc.; ESI Mail Pharmacy Service, Inc.; Express Scripts Pharmacy, Inc.; OptumRx, Inc.; OptumInsight, Inc.; OptumInsight Life Sciences, Inc.; CVS Health Corporation; Caremark Rx, L.L.C.; CaremarkPCS Health L.L.C.; Maryland CVS Pharmacy L.L.C.; and CVS Pharmacy, Inc. Id. The County’s claims arise out of the ongoing opioid epidemic and Defendants’ alleged role in causing and fueling that public health crisis. See generally id. Currently pending are four motions: (1) OptumInsight, Inc. and OptumInsight Life Sciences, Inc.’s (collectively, “OptumInsight Entities”) Motion to Dismiss (ECF No. 53); (2) Defendants’ Motion to Dismiss (ECF No. 56); (3) Defendants’ Motion for Certification of 1 Questions to Supreme Court of Maryland (ECF No. 76); and (4) OptumRx, Inc.’s (“OptumRx”) Motion to Disqualify Motley Rice (ECF No. 84). The motions are fully briefed and ripe for disposition. No hearing is necessary. See Loc. R. 105.6 (D. Md. 2023). For the reasons set forth below, the Court shall GRANT OptumInsight Entities’ Motion to Dismiss, DENY without

prejudice Defendants’ Motion to Dismiss, GRANT Defendants’ Motion for Certification of Questions to Supreme Court of Maryland, and DENY OptumRx’s Motion to Disqualify Motley Rice. I. BACKGROUND A. Factual Background

The County contends that Defendants caused and maintained a public nuisance by collaborating and partnering with opioid manufacturers in deceptive and dangerous marketing of opioids for financial gain, and by spurring opioid abuse by placing these drugs on formularies1 with preferred status and without restrictions on their approval for use. Amend. Compl. ¶ 1. Most of the Defendants are pharmacy benefit managers (“PBMs”). Id. ¶¶ 15–16. PBMs are “administrators hired by third-party payers (e.g., government entities, insurers, employers) to design and administer prescription drug programs.” Id. ¶ 16. PBMs design prescription drug benefit programs and create national formularies that set the criteria and terms under which pharmaceutical drugs are reimbursed, and review and pay claims for benefits. Id. ¶¶ 100–01. They determine what medications are most effective for each therapeutic use, the number of pills per

1 A formulary is “[a] list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits.” Formulary, HealthCare.gov, available at https://www.healthcare.gov/glossary/formulary/ (last accessed on January 14, 2025). 2 prescription, the number of refills permitted, any pre-authorization requirements, co-payment amounts, and other criteria. Id. ¶¶ 98–101. A PBM’s plan can determine what medications will, or will not be, available, at what quantity and dosage, and how difficult it may be for a patient to receive that medication. Id. ¶ 103. Thus, according to the County, PBMs wield direct, intentional

control and influence over the prescribing, dispensing, reimbursement, and consumption of opioids. Id. ¶¶ 105–07. Each Defendant operated as PBMs in Anne Arundel County and/or dispensed prescription opioids in Anne Arundel County. Id. ¶¶ 26, 109–11. The County alleges that Defendants have operated behind the scenes to fuel the opioid crisis while concealing their role and claiming concern for public health. Id. ¶¶ 17–18. The following summary of allegations is drawn from the County’s Amended Complaint (ECF No. 55). A few large PBMs, including PBM Defendants,2 exert substantial, but opaque, influence over the prescription-drug supply chain. Id. ¶¶ 98–127. The PBM Defendants had access to data indicating that opioids were being diverted, misused, and abused, but failed to use that data to make meaningful efforts to prevent opioid diversion. Id. ¶¶ 128–66. Instead, the PBM Defendants worked directly with opioid

manufacturers to boost opioid sales and aid in deceptive marketing. Id. ¶¶ 167–97. The PBM Defendants facilitated and encouraged the use of opioids and flooded the market through their formulary and benefit management decisions. Id. ¶¶ 198–235. Defendants ignored obligations they had under federal and state law in selling opioids from mail-order and retail pharmacies. Id. ¶¶ 248–65, 263–303. They helped create the public health crisis in Anne Arundel County by increasing the availability of opioids while concealing their conduct. Id. 304–31.

2 PBM Defendants include Express Scripts, Inc.; Express Scripts Administrators, LLC; Medco Health Solutions; ESI Mail Pharmacy Service, Inc.; Express Scripts Pharmacy, Inc.; OptumRx, Inc.; OptumInsight, Inc.; OptumInsight Life Sciences, Inc.; CaremarkPCS Health LLC; and Caremark, LLC. 3 B. Procedural Background On January 10, 2024, this case was removed from the Circuit Court for Anne Arundel County, Maryland to this Court. ECF No. 1. The County filed its Amended Complaint, on March 22, 2024, alleging one count of public nuisance. Am. Compl. (ECF No. 55). The same day, the

OptumInsight Entities filed a Motion to Dismiss for Lack of Jurisdiction, ECF No. 53, and Defendants filed a Motion to Dismiss for Failure to State a Claim, ECF No. 56. Defendants later filed a Motion for Certification of Questions to Supreme Court of Maryland. ECF No. 76. Finally, OptumRx filed a Motion to Disqualify Motley Rice. ECF No. 84. All pending motions are fully briefed.

II. OPTUMINSIGHT ENTITIES’ MOTION TO DISMISS A. Standard of Review When a party challenges the court’s power to exercise personal jurisdiction under Rule 12(b)(2) of the Federal Rules of Civil Procedure, “the jurisdictional question is to be resolved by the judge, with the burden on the plaintiff ultimately to prove grounds for jurisdiction by a preponderance of the evidence.” Orbita Telecom SAC v. Juvare LLC, 606 F. Supp. 3d 240, 247 (D. Md. 2022) (quoting Carefirst of Md., Inc. v. Carefirst Pregnancy Ctrs., Inc., 334 F.3d 390, 396 (4th Cir. 2003)). “If the court chooses to rule without conducting an evidentiary hearing, relying solely on the basis of the complaint, affidavits, and discovery materials, ‘the plaintiff need only make a prima facie showing of personal jurisdiction.’” Id. (quoting Carefist of Md., 334 F.3d at

396). The Fourth Circuit has explained that jurisdictional allegations are to be construed “in the light most favorable to the plaintiff,” and “the most favorable inferences” must be drawn in favor of the existence of jurisdiction. New Wellington Fin. Corp. v. Flagship Resort Dev. Corp., 416 F.3d 290, 294 (4th Cir. 2005). 4 Jurisdictional discovery is proper when the plaintiff has alleged sufficient facts to suggest the possible existence of personal jurisdiction. Pandit v. Pandit, 808 F. App’x 179, 183 (4th Cir. 2020) (citing Carefirst of Md., 334 F.3d at 402–03). However, “[w]hen a plaintiff offers only speculation or conclusory assertions about contacts with a forum state, a court is within its

discretion in denying jurisdictional discovery.” Id. (quoting Carefirst of Md., 334 F.3d at 402). B.

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