Sheet Metal Workers Local No. 20 Welfare and Benefit Fund; and Indiana Carpenters Welfare Fund v. CVS Pharmacy, Inc.; Plumbers Welfare Fund, Local 130 v. CVS Pharmacy, Inc.

CourtDistrict Court, D. Rhode Island
DecidedFebruary 3, 2026
Docket1:16-cv-00046
StatusUnknown

This text of Sheet Metal Workers Local No. 20 Welfare and Benefit Fund; and Indiana Carpenters Welfare Fund v. CVS Pharmacy, Inc.; Plumbers Welfare Fund, Local 130 v. CVS Pharmacy, Inc. (Sheet Metal Workers Local No. 20 Welfare and Benefit Fund; and Indiana Carpenters Welfare Fund v. CVS Pharmacy, Inc.; Plumbers Welfare Fund, Local 130 v. CVS Pharmacy, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sheet Metal Workers Local No. 20 Welfare and Benefit Fund; and Indiana Carpenters Welfare Fund v. CVS Pharmacy, Inc.; Plumbers Welfare Fund, Local 130 v. CVS Pharmacy, Inc., (D.R.I. 2026).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND

) SHEET METAL WORKERS LOCAL ) NO. 20 WELFARE AND BENEFIT ) FUND; and INDIANA CARPENTERS ) WELFARE FUND, ) ) , ) C.A. No. 16-cv-046-JJM-PAS Plaintiffs, ) ) v. ) ) CVS PHARMACY, INC., ) Defendant. ) )

) PLUMBERS WELFARE FUND, ) LOCAL 130, ) , ) Plaintiff, ) ) C.A. No. 16-cv-447-JJM-PAS v. ) ) CVS PHARMACY, INC., ) Defendant. ) )

MEMORANDUM AND ORDER JOHN J. MCCONNELL, JR., Chief Judge, United States District Court Plaintiffs are members of a class action lawsuit brought against CVS Pharmacy, Inc. (“CVS”). Plaintiffs have filed a motion, ECF No. 273,1 requesting that this Court reconsider its prior Arbitration Orders, which had the effect of placing

1 All ECF Nos. in this order correspond with the lead case number, No. 16-cv- 046-JJM-PAS. some of the class members into subclasses and staying their claims. ECF No. 238; Text Order (Feb. 14, 2025). For the reasons that follow, the Court GRANTS Plaintiffs’ Motion. Upon

reconsideration, the Court finds that the law of the First Circuit—specifically, the law governing nonsignatory enforcement of arbitration agreements—has changed such that the Court must lift its stay, eliminate the previously created subclasses, and allow some of the class members’ claims to proceed while dismissing the claims of other class members. I. FACTUAL AND PROCEDURAL BACKGROUND This is a class action consisting of two consolidated cases. Plaintiffs are third-

party payors (“TPPs”) or health plans2 that offer their members prescription drug insurance at subsidized or reduced costs. ECF No. 171 at 10. CVS is one of the defendants in this lawsuit. There are also various pharmacy benefit managers (“PBMs”) that have been involved in this case in various capacities, including Caremark,3 OptumRx,4 Express Scripts,5 Medco,6 and MedImpact. at 11. The

2 “Health plans” refer to insurance companies, governmental programs (like Medicare or Medicaid), and insurance plans sponsored by employers, pension plans, or union-affiliated trust funds. ECF No. 171 at 10-11; ECF No. 276-1 at 5. 3 As of May 23, 2024, Defendant Caremark has been dismissed from this lawsuit. ECF No. 238 at 4-5. 4 As of December 11, 2025, the parties have jointly stipulated to amend the class definition to exclude claims against Defendant OptumRx. ECF No. 285. The Court entered that stipulation a day later. Text Order (Dec. 12, 2025). Accordingly, CVS’s prior Motion to Exclude Certain OptumRx-Related Absent Class Members, or in the alternative, to Dismiss Their Claims (ECF No. 269) is now moot. 5 There is a pending motion by CVS to amend the class definition to exclude class members related to Express Scripts. ECF No. 276. The Court leaves resolution of this motion for another day. 6 As of 2012, Express Scripts acquired Medco. ECF No. 273 at 5 n.17. PBMs act as middleperson between the TPPs and CVS by, among other things, negotiating drug prices on behalf of the TPPs. ECF No. 171 at 11. Plaintiffs first brought claims against CVS nearly a decade ago,7 alleging

violations of the Racketeer Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. § 1961, , and state consumer protection acts, as well as claims for negligent misrepresentation, fraud, and unjust enrichment. at 5. In essence, Plaintiffs assert that CVS conspired with certain PBMs to defraud and overcharge Plaintiffs for prescription drugs. ECF No. 171 at 3-4. On May 11, 2021, Judge William E. Smith8 certified a “Nationwide Class.”9 ECF No. 179. This class is composed of over 5,000 TPPs who contracted with the

PBMs (i.e., “the TPP-PBM contracts”). ECF No. 174 at 1. Crucially, CVS is not a party to any of these TPP-PBM contracts. ; ECF No. 279 at 1.

7 Plaintiffs’ first complaint was filed on February 1, 2016. ECF No. 1. That complaint has since been amended by Plaintiffs. ECF No. 171. 8 Judge Smith retired from judicial service on January 21, 2026, and this case was randomly assigned to the current presiding judge. Text Order (Aug. 27, 2025). 9 The “Nationwide Class” is as follows: All health plans that, at any time between November 2008 and February 1, 2016, (1) had Caremark, L.L.C., Express Scripts, Medco, OptumRx, or MedImpact (or any of their predecessors) as their pharmacy benefit managers, (2) paid for generic prescription drugs purchased from CVS that were included in CVS’s Health Savings Pass program, and (3) paid for those drugs based on a formula containing Usual and Customary price. ECF No. 179 at 21, 77. Judge Smith also certified three other classes in this case: (1) an Unjust Enrichment Class; (2) an Unfair and Deceptive Conduct Consumer Protection Class; and (3) an Omission Consumer Protection Class. at 21-22, 77. In its certification order, the Court acknowledged that, because some class members may be subject to mandatory arbitration, “Defendants may pursue … motions to compel arbitration and/or dismiss following class certification, and the

Court will employ the procedural tools at its disposable to exclude those TPPs from the class or place them in a subclass.” ECF No. 179 at 58-59. As part of the discovery process, the PBMs began to produce their contracts with the TPPs. Several of these contracts contain alternative dispute resolution (“ADR”) provisions, which require the parties to submit to either arbitration or mediation. Accordingly, in 2023, PBM Caremark and CVS filed separate motions to compel Plaintiffs to submit to the ADR provisions or, in the alternative, to dismiss

from the class any absent class member TPP with an ADR provision in its contract with Caremark. ECF Nos. 211, 213. This classification applied to approximately 2,374 TPPs that had contracts with Caremark. ECF No. 273 at 5. On May 30, 2024, Judge Smith issued an order that made several key holdings. ECF No. 238. First, the Court dismissed Caremark from this lawsuit entirely. at 4-5. Second, the Court put certain absent class members into a

“subclass” (i.e., “the Caremark Subclass”) and temporarily stayed those subclass members’ claims. at 8. The Caremark Subclass is specifically composed of 2,312 TPPs whose contracts with Caremark have arbitration agreements that contain “delegation clauses,” which delegate “questions of arbitrability” to an arbitrator. at 6-8. Third, of the approximately 348 TPPs whose contracts with Caremark have ADR provisions that do contain delegation clauses,10 the Court analyzed whether CVS—as a nonsignatory to those contracts—could require Plaintiffs to submit to the contracts’ ADR processes under state law principles of equitable estoppel. at 8-

10. The Court sent to arbitration and dismissed the claims of those TPPs with non- delegated ADR agreements governed by California, Delaware, Florida, Georgia, Hawaii, Iowa, Massachusetts, New York, Ohio, Tennessee, Texas, and Virginia law.11 at 24. By contrast, the Court allowed to proceed the claims of those TPPs with non-delegated ADR agreements governed by Alabama, Colorado, Idaho, Illinois, Indiana, and New Jersey law.12 A few months later, CVS filed another motion—this time to dismiss from the

class any absent class member TPP with an arbitration provision in its contract with PBM MedImpact. ECF No. 253 at 1. Relying on the reasoning from his previous order, Judge Smith created another subclass for absent class members whose contracts with MedImpact contain arbitration provisions with delegation clauses (i.e.,

10 Approximately 62 of these “non-delegated” contracts contain arbitration agreements and 286 contain mediation clauses. ECF No. 238 at 8. 11 These states employ some combination of the “rely on” test, the “concerted misconduct” test, or both for equitable estoppel. ECF No. 238 at 19-20, 22-23.

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Sheet Metal Workers Local No. 20 Welfare and Benefit Fund; and Indiana Carpenters Welfare Fund v. CVS Pharmacy, Inc.; Plumbers Welfare Fund, Local 130 v. CVS Pharmacy, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/sheet-metal-workers-local-no-20-welfare-and-benefit-fund-and-indiana-rid-2026.