Sheila Gluesing v. PrudentRx LLC; Caremark Rx LLC

CourtDistrict Court, D. Rhode Island
DecidedJuly 8, 2026
Docket1:24-cv-00549
StatusUnknown

This text of Sheila Gluesing v. PrudentRx LLC; Caremark Rx LLC (Sheila Gluesing v. PrudentRx LLC; Caremark Rx LLC) 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
Sheila Gluesing v. PrudentRx LLC; Caremark Rx LLC, (D.R.I. 2026).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND

) SHEILA GLUESING, ) ) , ) Plaintiff, ) ) v. ) ) No. 24-cv-549-JJM-AEM PRUDENTRX LLC, ) ; and ) ) CAREMARK RX LLC, ) , ) Defendants. ) )

MEMORANDUM AND ORDER JOHN J. MCCONNELL, JR., United States District Court Chief Judge. Sheila Gluesing has filed a class action lawsuit against PrudentRx LLC (“PrudentRx”) and Caremark Rx LLC (“Caremark”) (collectively, “Defendants”) under the Employee Retirement Income Security Act (“ERISA”) and the Racketeer Influenced and Corrupt Organizations (“RICO”) Act. ECF No. 1. She alleges that Defendants, along with CVS Specialty Pharmacy (“CVS Specialty”), engaged in a scheme to take copay assistance funds designed by drug manufacturers to help patients afford high-cost specialty prescription drugs and divert those funds to insurers rather than to the patients themselves, which resulted in the patients having to bear additional healthcare costs. Defendants have now filed a Renewed Motion to Compel Arbitration,1 seeking to send Ms. Gluesing’s claims into arbitration. ECF No. 63.2 Ms. Gluesing has filed a Response In Opposition to Defendants’ Motion. ECF No. 66.

For the reasons stated below, the Court GRANTS Defendants’ Motion to Compel Arbitration and, as Defendants have requested, this case will be STAYED pending arbitration. I. BACKGROUND In considering Defendants’ Renewed Motion to Compel Arbitration, the Court must “draw the relevant facts from the operative complaint and the documents submitted to the district court in support of the motion to compel arbitration.”

, 893 F.3d 53, 55 (1st Cir. 2018) (citing , 689 F.3d 1, 2 (1st Cir. 2012)). Ms. Gluesing is a resident of Iowa who receives health insurance through Wellmark Health Plan of Iowa (“Wellmark”). ECF No. 1 at 6. Wellmark, in turn, contracts with Caremark for pharmacy benefit manager (“PBM”) services. As a PBM, Caremark negotiates with pharmacies to provide insurers (including both

insurance companies and employers that sponsor health plans for their employees) with discounted prices (also known as “rebates”) on prescription drugs. at 2, 18.

1 Defendants previously moved to compel arbitration on March 6, 2025. ECF No. 21. However, the Court denied that motion without prejudice, permitted the parties to engage in “limited discovery on the issue of economic duress,” and advised Defendants that they could later file a renewed motion to compel arbitration. ECF No. 38. 2 All citations to the parties’ briefs and exhibits refer to each of the unsealed docket filings on ECF, as opposed to the sealed versions of those filings. In addition, Caremark administers prescription benefits for those members enrolled in the insurers’ health plans. at 9, 18. Wellmark also participates in the PrudentRx Copay Program (the “Program”),

which was designed by PrudentRx. ECF No. 1 at 4, 7. For those patients enrolled in the Program, PrudentRx offers that “they will enjoy a $0 copay for their qualifying specialty medications.” at 28. PrudentRx operates the Program with Caremark and CVS Specialty. at 13. PrudentRx also works with Caremark to market the Program to health plan sponsors and, once a sponsor agrees to join, the sponsor’s “eligible members” are enrolled in the Program. at 13, 28. In March 2022, Ms. Gluesing was prescribed Dupixent, which is a medication

used to treat atopic dermatitis and psoriasis. ECF No. 63 at 5 (citing ECF No. 63-6 [Ex. E, Mittal Decl.] at 3–4). Dupixent qualifies as a “specialty drug,” which generally refers to a high-cost prescription medication used to treat complex and serious health conditions, such as cancer, multiple sclerosis, and autoimmune disorders. ECF No. 1 at 1–2. As part of her health insurance plan with Wellmark, Ms. Gluesing “must

purchase specialty drugs through the specialty pharmacy program” for those drugs to be covered by her insurance, and the “specialty pharmacy program is limited to CVS Specialty.” ECF No. 63 at 5 (citing ECF No. 63-5 [Ex. D, Mittal Decl.] at 53). In addition, Ms. Gluesing is enrolled in the PrudentRx Copay Program through her Wellmark plan. ECF No. 1 at 7. On April 1, 2022, as part of her preparations to fill her Dupixent prescription through CVS Specialty, Ms. Gluesing alleges that “a CVS Specialty online account was created using [her] email address.” ECF No. 66 at 3. Ms. Gluesing states that

she “does not recall creating the account,” and she “believes her healthcare provider’s office may have created the account for her[.]” at 4. As part of the CVS Specialty online account registration process, there is a webpage that asks users to click a box stating: “I agree to the CVS Specialty Terms and Conditions.” ECF No. 63 at 6 (citing ECF No. 63-10 [Howell Decl.] at 2; ECF No. 63-13 [Ex. C, Howell Decl.] at 2). The words “CVS Specialty Terms and Conditions” contained a hyperlink to the full CVS Specialty Terms of Use (“CVS Specialty Terms”

or “Terms”) that were in effect in 2022. The Terms then in effect contained a “Dispute Resolution” provision that states, in relevant part: EXCEPT FOR DISPUTES THAT QUALIFY FOR SMALL CLAIMS COURT, ALL DISPUTES ARISING OUT OF OR RELATED TO THIS AGREEMENT OR ANY ASPECT OF THE RELATIONSHIP BETWEEN YOU, ON THE ONE HAND, AND CVS/SPECIALTY OR ITS SUPPLIERS OR VENDORS, ON THE OTHER HAND, WHETHER BASED IN CONTRACT, TORT, STATUTE, FRAUD, MISREPRESENTATION, OR ANY OTHER LEGAL THEORY, WILL BE RESOLVED THROUGH FINAL AND BINDING ARBITRATION BEFORE A NEUTRAL ARBITRATOR INSTEAD OF IN A COURT BY A JUDGE OR JURY AND YOU AGREE THAT CVS/SPECIALTY AND YOU ARE EACH WAIVING THE RIGHT TO TRIAL BY A JURY. YOU AGREE THAT ANY ARBITRATION UNDER THIS AGREEMENT WILL TAKE PLACE ON AN INDIVIDUAL BASIS; CLASS ARBITRATIONS AND CLASS ACTIONS ARE NOT PERMITTED AND YOU ARE AGREEING TO GIVE UP THE ABILITY TO PARTICIPATE IN A CLASS ACTION. The arbitration will be administered by the American Arbitration Association (“AAA”) under its Consumer Arbitration Rules . . . as amended by this Agreement. (quoting ECF No. 63-14 [Ex. D, Howell Decl.] at 16). Ms. Gluesing later discovered that certain drug manufacturers (such as the manufacturers of Dupixent) offer copay assistance programs that are designed to help patients afford expensive specialty drugs. ECF No. 1 at 7, 21. However, she alleges

that the PrudentRx Copay Program diverts copay assistance program funds to insurers rather than to the patients themselves, which results in the patients having to bear additional healthcare costs. at 1. On December 26, 2024, Ms. Gluesing brought ERISA and RICO claims on behalf of herself and on behalf of others similarly situated. ECF No. 1 at 1. She alleges that the PrudentRx Copay Program violates the Affordable Care Act (“ACA”) because it “deprives patients of the benefits of patient copay assistance funding and

increases patients’ healthcare costs.” Specifically, Ms. Gluesing accuses Defendants and CVS Specialty of running a “fraudulent enterprise . . . to divert hundreds of millions, if not billions, of dollars in funding meant to help patients, to insurance plans and enrich themselves instead.” Defendants have responded by filing a Renewed Motion to Compel Arbitration. ECF No. 63. II. STANDARD OF REVIEW

The Federal Arbitration Act (“FAA”) governs the Court’s review of Defendants’ Motion. 9 U.S.C. §§ 1–16. “[T]he FAA requires courts to treat arbitration as ‘a matter of contract’ and enforce agreements to arbitrate ‘according to their terms.’” , 21 F.4th 168, 174 (1st Cir. 2021) (quoting , 586 U.S. 63, 67 (2019)). “Parties are not obliged to arbitrate, however, ‘when they have not agreed to do so.’” , 101 F.4th 99, 103 (1st Cir. 2024) (quoting , 913 F.3d 200, 207 (1st Cir. 2019)).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Prima Paint Corp. v. Flood & Conklin Mfg. Co.
388 U.S. 395 (Supreme Court, 1967)
Perry v. Thomas
482 U.S. 483 (Supreme Court, 1987)
First Options of Chicago, Inc. v. Kaplan
514 U.S. 938 (Supreme Court, 1995)
Buckeye Check Cashing, Inc. v. Cardegna
546 U.S. 440 (Supreme Court, 2006)
Arthur Andersen LLP v. Carlisle
556 U.S. 624 (Supreme Court, 2009)
McCarthy v. Azure
22 F.3d 351 (First Circuit, 1994)
Intergen N v. v. Grina
344 F.3d 134 (First Circuit, 2003)
Awuah v. Coverall North America, Inc.
554 F.3d 7 (First Circuit, 2009)
Dialysis Access Center, LLC v. RMS Lifeline, Inc.
638 F.3d 367 (First Circuit, 2011)
Soto v. STATE INDUSTRIAL PRODUCTS, INC.
642 F.3d 67 (First Circuit, 2011)
register.com, Inc. v. Verio, Inc.
356 F.3d 393 (Second Circuit, 2004)
Gove v. Career Systems Development Corp.
689 F.3d 1 (First Circuit, 2012)
Schnabel v. Trilegiant Corp. & Affinion, Inc.
697 F.3d 110 (Second Circuit, 2012)
Louros v. Cyr
175 F. Supp. 2d 497 (S.D. New York, 2001)
Joseph Martin, Jr., Delicatessen, Inc. v. Schumacher
417 N.E.2d 541 (New York Court of Appeals, 1981)
Kevin Nguyen v. Barnes & Noble Inc.
763 F.3d 1171 (Ninth Circuit, 2014)
Farnsworth, III v. Towboat Nantucket Sound, Inc.
790 F.3d 90 (First Circuit, 2015)
Gary Sgouros v. TransUnion Corporation
817 F.3d 1029 (Seventh Circuit, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
Sheila Gluesing v. PrudentRx LLC; Caremark Rx LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sheila-gluesing-v-prudentrx-llc-caremark-rx-llc-rid-2026.