Russo v. Walgreen Co.

CourtDistrict Court, N.D. Illinois
DecidedMarch 9, 2018
Docket1:17-cv-02246
StatusUnknown

This text of Russo v. Walgreen Co. (Russo v. Walgreen Co.) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Russo v. Walgreen Co., (N.D. Ill. 2018).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

DOROTHY FORTH, TROY TERMINE, ) CYNTHIA RUSSO, INTERNATIONAL ) BROTHERHOOD OF ELECTRICAL ) WORKERS LOCAL 38 HEALTH AND ) WELFARE FUND, LISA BULLARD, ) AND RICARDO GONZALES, on ) behalf of themselves and all others ) 17-cv-2246 similarly situated, ) ) Judge John Z. Lee Plaintiffs, ) ) v. ) ) WALGREEN CO., ) ) Defendant. )

MEMORANDUM OPINION AND ORDER Plaintiffs Dorothy Forth, Troy Termine, Cynthia Russo, Lisa Bullard, and Ricardo Gonzales (“Consumer Plaintiffs”), and Plaintiff International Brotherhood of Electrical Workers Local 38 Health and Welfare Fund (“IBEW”) (collectively, “Plaintiffs”), filed this putative class action against Defendant Walgreen Co. (“Walgreens”). Plaintiffs claim that Walgreens, the largest retail pharmacy in the United States, engaged in fraudulent pricing practices through its Prescription Savings Club, a discount generic drug program offered to customers paying without insurance. According to Plaintiffs, these fraudulent pricing practices sought to artificially inflate the “usual and customary prices” reported to health-insurance companies and related third-party payors and resulted in Plaintiffs overpaying for generic drugs. Plaintiffs plead claims of fraud, negligent misrepresentation, and unjust enrichment, as well as violations of state consumer-protection statutes in nineteen states. 1 They also seek declaratory and injunctive relief under the

Declaratory Judgment Act, 28 U.S.C. § 2201, et seq. Walgreens moves to dismiss all but one claim 2 in the First Amended Complaint for failure to state a claim, failure to plead the fraud claims with particularity, and lack of standing to pursue injunctive relief. For the reasons provided below, the Court grants in part and denies in part the motion to dismiss. Factual Background3

Walgreens is the largest retail pharmacy in the United States, with over 8,000 retail pharmacies in all fifty states. Am. Compl. ¶ 7, ECF No. 46. Its retail pharmacy operations are directed from its Deerfield, Illinois, headquarters, where its key executives are located. Id. ¶¶ 36, 39, 41. Consumer Plaintiffs are individuals, who purchased generic versions of prescription medications at Walgreens either through private health insurance plans

1 Plaintiffs plead violations of state consumer protection statutes in the following states: Arizona, California, Colorado, Florida, Georgia, Illinois, Louisiana, Massachusetts, Minnesota, Missouri, Nevada, New Mexico, New York, North Carolina, Ohio, South Carolina, Texas, and Wisconsin. See Am. Compl. Counts IV–XXVIII. The Amended Complaint also includes a claim for violation of the Kansas Consumer Protection Act (Count XIV), but Plaintiffs have since withdrawn this claim. See Pls.’ Resp. Mot. Dismiss at 15 n.11, ECF No. 62. 2 While Walgreens purports to move to dismiss the entire complaint, see Def.’s Mem. Supp. Mot. Dismiss at 2, it does not move to dismiss the unjust enrichment claim (Count III). 3 The following facts are taken from Plaintiffs’ Amended Complaint and are accepted as true on review of the motion to dismiss. See Tamayo v. Blagojevich, 526 F.3d 1074, 1081 (7th Cir. 2008) (stating that, at the motion-to-dismiss stage, the court “accept[s] as true all well- pleaded facts alleged”). or through federal health insurance such as Medicare, in the states of Texas, Louisiana, Florida, Massachusetts, New Mexico, Wisconsin, and South Carolina. Id. ¶¶ 14, 17, 20, 23, 26.

IBEW is an employee-benefit plan and a non-profit trust, administered by a board of trustees and established through collective bargaining by employers and labor unions. Id. ¶¶ 29, 30. It provides healthcare benefits to participants employed under various collective-bargaining agreements and their dependents. Id. ¶ 30. While IBEW is based in Ohio, its beneficiaries are located in Arizona, California, Colorado, Florida, Georgia, Iowa, Illinois, Kansas, Louisiana, Minnesota, Missouri,

Nevada, North Carolina, Ohio, South Carolina, Texas, and Wisconsin. Id. Since 2007, Walgreens has operated a discount generic-drug program called the “Prescription Savings Club” (“PSC”). Id. ¶¶ 4, 8. The PSC allows customers that pay directly for prescriptions, whether by cash, check, or credit, to purchase more than 500 widely prescribed generic drugs for $5, $10, and $15 for 30-day prescriptions, and $10, $20, and $30 for 90-day prescriptions, depending on the drug’s tier classification. Id. ¶ 8. To take advantage of the PSC’s prices, customers

must pay a yearly membership fee of $20 per individual or $30 per family. Am. Compl. Ex. A, Value-Priced Medication List, ECF No. 46-1. All pharmacy patrons other than Medicare and Medicaid beneficiaries are eligible to participate in the PSC, and a majority of Walgreens’ direct-pay4 customers pay the PSC prices. Am. Compl. ¶¶ 10, 11. The complaint alleges that, at the same time it offered low prices through the

PSC to direct-pay customers, Walgreens charged higher prices to customers purchasing those same drugs through private insurance or through Medicare or Medicaid. Id. ¶ 12. According to Plaintiffs, pharmacies cannot charge such consumers—or report to insurance companies or other third-party providers (such as Medicare and Medicaid)—a higher price for prescription drugs than what is known as the “usual and customary” (“U&C”) price. Id. ¶ 5. Plaintiffs allege that the U&C

price is known, throughout the pharmaceutical industry, as the price that the pharmacy charges the direct-pay public. Id.; see also id. ¶ 53 (providing examples of industry sources defining the U&C price). Plaintiffs contend that Walgreens’ PSC prices qualified as the pharmacy’s U&C prices, and that by reporting higher-than- PSC prices as its U&C prices on claims for reimbursement submitted to insurance companies and other third-party providers, Walgreens operated an undisclosed, dual- pricing scheme for generic PSC-listed drugs. Id. ¶ 12.

Plaintiffs allege significant damages due to Walgreens’ dual-pricing scheme. Id. ¶ 13. Because the reported U&C price is used to calculate the amount of copayments, coinsurance or deductible amounts, Plaintiffs claim that Walgreens overcharged Plaintiffs and other consumers when it collected from them inflated

4 The Court uses “direct-pay” to indicate those customers, who pay for prescriptions without using health insurance, Medicare, or Medicaid. copayments, coinsurance and deductibles. Id. ¶ 12. For example, Plaintiff Forth alleges that Walgreens overcharged her by $285 for fifteen prescription purchases of PSC-listed generic drugs. Id. ¶ 14. These purchases included six prescriptions for

which she was charged more than $40, but for which the PSC-listed price was $15. Id. Plaintiff Forth and the other Consumer Plaintiffs claim that they were under the impression that, because they had health insurance with prescription benefits coverage, they would not be paying more than direct-pay customers for their prescriptions. Id. ¶¶ 15, 18, 21, 24, 27. All Consumer Plaintiffs anticipate filling future prescriptions for PSC-covered drugs at a Walgreens pharmacy to maintain

continuity of medical care. Id. ¶¶ 16. 19, 22, 25, 28. Finally, IBEW asserts that because it reimburses or pays for its beneficiaries’ purchases of prescription drugs, it was harmed by paying more for PSC-listed generic drugs than it would have if Walgreens had accurately reported its U&C prices. Id. ¶ 30. Legal Standards To survive a motion to dismiss under Rule 12(b)(6), a complaint must “state a claim to relief that is plausible on its face.” Bell Atl. Corp. v.

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