Express Scripts v. Anne Arundel Cnty.

CourtCourt of Appeals of Maryland
DecidedMarch 23, 2026
Docket1m/25
StatusPublished

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

Bluebook
Express Scripts v. Anne Arundel Cnty., (Md. 2026).

Opinion

Express Scripts, Inc., et al. v. Anne Arundel County, Maryland, Misc. No. 1, September Term, 2025, Opinion by Booth, J.

CERTIFIED QUESTION—MARYLAND COMMON LAW OF PUBLIC NUISANCE

Pursuant to a certification order from the United States District Court for the District of Maryland, the Supreme Court of Maryland (“Supreme Court”) was requested to answer the following questions:

1. Under Maryland’s common law, can the licensed dispensing of, or administration of benefit plans for, a controlled substance constitute an actionable public nuisance?

2. If so, what are the elements of such a public nuisance claim, and what types of potential relief can a local government plaintiff seek when asserting such a claim? The Supreme Court held that the licensed dispensing of, or administration of benefit plans for, a controlled substance does not constitute an actionable public nuisance under Maryland common law. Maryland has not expanded the public nuisance doctrine beyond the traditional historical principles embodied in the common law—namely, that a public nuisance action was not regarded as a tort but was instead a public action by a government entity to pursue criminal prosecutions or seek injunctive relief to abate harmful conduct. The Court has never recognized a government actor’s ability to recover damages for public nuisance.

The Court determined that it did not need to decide whether to expand Maryland’s common law of public nuisance because Anne Arundel County’s complaint against licensed pharmacies and pharmacy benefit managers fails to satisfy a primary requirement of a public nuisance action—specifically, that the defendants’ conduct of dispensing opioids, and the administration of benefit plans for opioids, affects a common public right. Moreover, even if the County were able to establish that the alleged conduct interfered with a common public right, the Court recognized that judicial restraint is the best course given the extensive federal and state statutory and regulatory framework that governs the highly complex conduct of the licensed prescribing, dispensing, and administration of benefit plans related to opioids. Common law public nuisance is an inapt vehicle to address complex societal problems, which are best left to the legislative branch. United States District Court for the District of Maryland Case No.: Civ. No. 1:24-cv-00090-MJM Argued: September 9, 2025

IN THE SUPREME COURT

OF MARYLAND

Misc. No. 1

September Term, 2025

EXPRESS SCRIPTS, INC., et al.

v.

ANNE ARUNDEL COUNTY, MARYLAND

Fader, C.J., Watts, Booth, Biran, Gould, Eaves, Killough,

JJ.

Opinion by Booth, J. Killough, J., concurs. Watts, J., concurs and dissents.

Filed: March 23, 2026 Pursuant to the Maryland Uniform Electronic Legal Materials Act (§§ 10-1601 et seq. of the State Government Article) this document is authentic.

2026.03.23 12:24:25 -04'00' Gregory Hilton, Clerk This case comes to us from the United States District Court for the District of

Maryland (the “District Court”) pursuant to a certification order 1 requesting that we answer F

the following questions:

1. Under Maryland’s common law, can the licensed dispensing of, or administration of benefit plans for, a controlled substance constitute an actionable public nuisance?

2. If so, what are the elements of such a public nuisance claim, and what types of potential relief can a local government plaintiff seek when asserting such a claim? We answer “no” to the first question. We hold that the licensed dispensing of, or

administration of benefit plans for, a controlled substance does not constitute an actionable

public nuisance. As discussed herein, Maryland’s public nuisance common law has not

been expanded beyond the traditional historical principles—namely, that an action for

public nuisance brought by a governmental entity on behalf of the public was not regarded

as a tort, but instead as a basis for public officials to pursue criminal prosecutions or seek

injunctive relief to abate harmful conduct. Although damages may be available in a private

nuisance action (as they were under the common law), this Court has never recognized a

government actor’s ability to recover damages in a public nuisance action.

We do not need to decide in this case whether to expand our common law of public

nuisance because the County’s complaint fails to satisfy a primary requirement of a public

1 Under the Maryland Uniform Certification of Questions of Law Act, Md. Code (2020 Repl. Vol., 2025 Supp.), Courts & Judicial Proceedings Article (“CJ”) §§ 12-601 et seq., the court certifying the question shall issue a certification order containing “(1) [t]he question of law to be answered; [and] (2) [t]he facts relevant to the question, showing fully the nature of the controversy out of which the question arose[.]” CJ § 12- 606(a). nuisance action—specifically, that the Defendants’ conduct of dispensing opioids, and the

administration of benefit plans for opioids, affects a common public right. But even if the

County were able to establish that the alleged conduct interfered with a public right, we

would nonetheless decline to expand our common law of public nuisance here given the

extensive federal and state statutory and regulatory framework that governs the highly

complex conduct of the licensed prescribing, dispensing, and administration of benefit

plans related to opioids.

I

Certification Order and the Parties’ Contentions

The certification order, and the operative complaint referenced therein, set forth the

following procedural history and facts, which we accept for the purpose of answering the

certified questions of law. United Bank v. Buckingham, 472 Md. 407, 412–13 (2021).

Appellee Anne Arundel County, Maryland (“the County”), a charter county of the

State of Maryland, brings this action against Express Scripts, Inc.; Express Scripts

Administrators, LLC; Medco Health Solutions, Inc.; ESI Mail Pharmacy Service, Inc.;

Express Scripts Pharmacy, Inc.; OptumRX, Inc.; CaremarkPCS Health, L.L.C.; Caremark,

L.L.C.; Maryland CVS Pharmacy, L.L.C.; and CVS Pharmacy, Inc. (collectively, “the

Defendants”).

The County’s lawsuit consists of a single public nuisance claim against the

Defendants, all of whom fall within three distinct categories: pharmacy benefit managers

2 (“PBMs”), mail-order pharmacies, or retail pharmacies. 2 The County contends that the 1F

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 formularies 3 with preferred status 2F

and without restriction on their approval for use.

The County’s public nuisance claim against the PBM Defendants arises out of their

actions to facilitate and encourage the use of opioids, allegedly flooding the market with

opioids through their formulary and benefit management decisions. As to the mail-order

and retail pharmacy Defendants, the County’s public nuisance claim arises out of those

Defendants’ actions in filling prescriptions for opioid medications in allegedly excessive

quantities and in an allegedly unsafe manner.

The County seeks the following relief: (1) a finding that the Defendants have created

a public nuisance and are jointly and severally liable; (2) an injunction permanently

enjoining the Defendants from “engaging in the acts and practices that caused the public

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Bluebook (online)
Express Scripts v. Anne Arundel Cnty., Counsel Stack Legal Research, https://law.counselstack.com/opinion/express-scripts-v-anne-arundel-cnty-md-2026.