Commw. of Ky. v. Express Scripts, Inc.

Court of Appeals for the Sixth Circuit·Decided September 18, 2026·No. 25-5866·Published

Opinion

RECOMMENDED FOR PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b)

File Name: 26a0268p.06

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

COMMONWEALTH OF KENTUCKY, ex rel. Russell │

Coleman, Attorney General, │

Plaintiff-Appellee, │ > No. 25-5866 │

v. │ │

EXPRESS SCRIPTS, INC.; ESI MAIL PHARMACY │ SERVICE, INC.; EXPRESS SCRIPTS PHARMACY, INC.; │ OPTUMRX, INC., │ Defendants-Appellants. │ ┘

Appeal from the United States District Court for the Eastern District of Kentucky at Lexington.

No. 5:24-cv-00303—Karen K. Caldwell, District Judge.

Decided and Filed: September 18, 2026

Before: SUTTON, Chief Judge; GIBBONS and DAVIS, Circuit Judges.

COUNSEL

ON BRIEF: Christopher G. Michel, Jonathan G. Cooper, Michael J. Lyle, QUINN EMANUEL URQUHART & SULLIVAN, LLP, Washington, D.C., Lisa M. Geary, Gregory P. Graham, QUINN EMANUEL URQUHART & SULLIVAN, LLP, New York, New York, Brian D. Boone, Caitlin Van Hoy, Matthew P. Hooker, ALSTON & BIRD LLP, Charlotte, North Carolina, Matthew P. McGuire, ALSTON & BIRD LLP, Raleigh, North Carolina, for Appellants. Matthew F. Kuhn, John H. Heyburn, Jacob M. Abrahamson, OFFICE OF THE KENTUCKY ATTORNEY GENERAL, Frankfort, Kentucky, Elizabeth Smith, MOTLEY RICE, Washington, D.C., Frederick C. Baker, MOTLEY RICE, Mount Pleasant, South Carolina, for Appellee.

No. 25-5866 Commw. of Ky. v. Express Scripts, Inc., et al. Page 2

OPINION

SUTTON, Chief Judge. The Commonwealth of Kentucky filed this lawsuit in state court, alleging that a group of healthcare firms contributed to Kentucky’s opioid crisis by conspiring with drug manufacturers to increase the supply of prescription opioids. The defendant firms include two Pharmacy Benefit Managers that negotiate with drug manufacturers to provide prescription drug coverage for federal employees. The Pharmacy Benefit Managers removed the case to federal court under the federal officer removal statute. Kentucky moved to remand, arguing that its complaint effectively disclaimed liability for any conduct the firms undertook at the behest of a federal officer. The district court agreed and granted Kentucky’s motion. In view of our decision in Ohio ex rel. Yost v. Ascent Health Services, LLC, 165 F.4th 999 (6th Cir. 2026), we reverse.

I.

Express Scripts and Optum are Pharmacy Benefit Managers—PBMs, for short. They serve as the prescription drug market’s middlemen, the intermediaries between drug manufacturers and health plans. PBMs administer prescription-drug benefits on behalf of their clients, which include federal and commercial plan sponsors. As part of that process, they help their clients develop formularies—lists of prescription drugs that health insurance plans cover— and negotiate discounts, often in the form of rebates, from drug companies seeking to list their products on the PBM’s formulary. Express Scripts serves plan sponsors that insure federal workers under the Federal Employees Health Benefits Act. It also provides PBM and mail-order pharmacy services for the Department of Defense’s TRICARE program. Optum contracts with the Veterans Health Administration to provide pharmacy benefit services to veterans and their families.

Kentucky sued the PBMs and several related companies in state court. The Commonwealth claims that the PBMs flooded its prescription drug market with opioids, violating state consumer protection law and creating a public nuisance. The PBMs did so,

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Kentucky alleges, by negotiating with drug manufacturers to give opioids “preferred placement on national formularies” in exchange for rebates, fees, and other payments. R.30 ¶ 11. Kentucky seeks several forms of relief, including a declaration that the PBMs willfully violated state law, civil monetary penalties, a permanent injunction, and a court order requiring abatement of a public nuisance.

Express Scripts and Optum removed the case to federal court under the federal officer removal statute. See 28 U.S.C. § 1442(a)(1). Kentucky moved to remand, and the district court granted its motion. Soon after, this court decided Ohio ex rel. Yost v. Ascent Health Services, LLC, 165 F.4th 999 (6th Cir. 2026). In the Yost lawsuit against nearly identical defendant PBMs, we rejected Ohio’s similar effort to avoid federal jurisdiction by disclaiming its intent to hold the PBMs liable for federally controlled conduct. Id. at 1008–09.

II.

Section 1442 allows a state-court defendant to remove a lawsuit against “any officer (or any person acting under that officer) of the United States or of any agency thereof, in an official or individual capacity, for or relating to any act under color of such office.” 28 U.S.C. § 1442(a)(1). The statute permits removal if the defendant establishes that: (1) he is a federal officer or a person “acting under” a federal officer, (2) the lawsuit targets conduct “for or relating to any act under color of [federal] office,” and (3) the lawsuit “involves a colorable federal defense.” Id.; Yost, 165 F.4th at 1004. A notice of removal requires a “short and plain statement of the grounds for removal.” 28 U.S.C. § 1446(a). When reviewing a remand to state court, we credit the removing defendant’s “plausible factual allegations,” Chevron USA Inc. v. Plaquemines Par., 608 U.S. 1, 12 (2026), and give fresh review to a district court’s remand order, Hudak v. Elmcroft of Sagamore Hills, 58 F.4th 845, 851 (6th Cir. 2023).

The three factors require us to permit removal of this case to federal court.

Person acting under an officer of the United States. The PBMs are persons who acted under an officer of the United States. The PBMs count as “person[s]” under the statute. Bennett v. MIS Corp., 607 F.3d 1076, 1085 (6th Cir. 2010); see Watson v. Philip Morris Cos., 551 U.S. 142, 147–48 (2007). A person acts under a federal officer when he makes “an effort to assist, or

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to help carry out” the federal superior’s own “duties or tasks,” and his relationship to the federal superior is “characterized by ‘subjection, guidance, or control.’” Yost, 165 F.4th at 1004 (quoting Watson, 551 U.S. at 151–52). Such a relationship “typically arises when a private contractor performs a task that the Government itself would [otherwise] have had to perform.” Id. (alteration in original) (quotation omitted).

The PBMs all “act[ed] under” a federal officer. 28 U.S.C. § 1442(a)(1). Start with Express Scripts. The Federal Employees Health Benefits Act charges the Office of Personnel Management with administering a “comprehensive” health insurance program for federal employees. Coventry Health Care of Mo., Inc. v. Nevils, 581 U.S. 87, 91 (2017) (quotation omitted). To discharge that duty, the Office contracts with commercial insurance carriers—the federal plan sponsors—and instructs them to subcontract with PBMs to secure coverage. See 5 U.S.C. § 8902(a); Yost, 165 F.4th at 1005. Negotiating prescription drug coverage comes with the Office’s duty to “negotiat[e] and regulat[e]” federal health plans. Empire Healthchoice Assurance, Inc. v. McVeigh, 547 U.S. 677, 683 (2006). If PBMs stopped playing this “key role,” Yost, 165 F.4th at 1005, the government would have to find its own seat at the bargaining table. In dealing with drug manufacturers on behalf of federal plan sponsors, Express Scripts thus helps the Office “carry out its FEHBA duties” by handling a duty it would otherwise have to perform. Id. (quotation omitted); see Watson, 551 U.S. at 154.

PBMs are not left to their own devices when they assist with these core federal duties.

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Commw. of Ky. v. Express Scripts, Inc., (6th Cir. 2026).

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