State of Utah and Division of Consumer Protection v. Express Scripts, Inc., Express Scripts Administrators, LLC, ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy, Inc., ESI Mail Order Processing, Inc., Medco Health Solutions, Inc., UnitedHealth Group, Inc., OptumRx Inc., OptumInsight Life Sciences, Inc., and OptumInsight, Inc.

CourtDistrict Court, D. Utah
DecidedMarch 31, 2026
Docket2:25-cv-00088
StatusUnknown

This text of State of Utah and Division of Consumer Protection v. Express Scripts, Inc., Express Scripts Administrators, LLC, ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy, Inc., ESI Mail Order Processing, Inc., Medco Health Solutions, Inc., UnitedHealth Group, Inc., OptumRx Inc., OptumInsight Life Sciences, Inc., and OptumInsight, Inc. (State of Utah and Division of Consumer Protection v. Express Scripts, Inc., Express Scripts Administrators, LLC, ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy, Inc., ESI Mail Order Processing, Inc., Medco Health Solutions, Inc., UnitedHealth Group, Inc., OptumRx Inc., OptumInsight Life Sciences, Inc., and OptumInsight, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State of Utah and Division of Consumer Protection v. Express Scripts, Inc., Express Scripts Administrators, LLC, ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy, Inc., ESI Mail Order Processing, Inc., Medco Health Solutions, Inc., UnitedHealth Group, Inc., OptumRx Inc., OptumInsight Life Sciences, Inc., and OptumInsight, Inc., (D. Utah 2026).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF UTAH

STATE OF UTAH and DIVISION OF CONSUMER PROTECTION, MEMORANDUM DECISION AND ORDER GRANTING PLAINTIFFS’ MOTION TO Plaintiffs, REMAND

v. Case No. 2:25-cv-00088-JNP-DBP EXPRESS SCRIPTS, INC., EXPRESS SCRIPTS ADMINISTRATORS, LLC, ESI Chief District Judge Jill N. Parrish MAIL PHARMACY SERVICE, INC, EXPRESS SCRIPTS PHARMACY, INC., Magistrate Judge Dustin B. Pead ESI MAIL ORDER PROCESSING, INC., MEDCO HEALTH SOLUTIONS, INC., UNITEDHEALTH GROUP, INC., OPTUMRX INC., OPTUMINSIGHT LIFE SCIENCES, INC., and OPTUMINSIGHT, INC.,

Defendants.

Plaintiffs the State of Utah and the Division of Consumer Protection (collectively “Utah”) brought this action in Utah state court against Defendants, raising claims arising from Defendants’ alleged role in causing the opioid epidemic. ECF No. 1-1 (“Compl.”). Several defendants (collectively “Removing Defendants”) filed a joint notice of removal, bringing the action before this court. ECF No. 1 (“Notice of Removal”). Utah now brings a motion to remand this action to state court, arguing that this court lacks subject matter jurisdiction. ECF No. 34 (“Pls.’ Mot.”).1 For the reasons discussed below, the motion is GRANTED. BACKGROUND Utah commenced this action against two groups of affiliated entities: (1) Express Scripts,

Inc., Express Scripts Administrators, LLC, Medco Health Solutions, ESI Mail Pharmacy Service, Inc., ESI Mail Order Processing, Inc., and Express Scripts Pharmacy, Inc. (collectively “Express Scripts”); and (2) UnitedHealth Group, Inc., OptumRx, Inc., OptumInsight, Inc., and OptumInsight Life Sciences, Inc. (collectively “Optum”). Compl. at 2. Express Scripts and Optum are two of the largest pharmacy benefit managers (“PBMs”). Id. ¶ 2. PBMs “manage prescription drug benefits plans sponsored by health insurers, self-insured employers, and other payers.” Id. ¶ 3. The First Circuit provides a helpful description of what this work, including the development of national formularies, entails: Think of PBMs as “middlemen” between health care plans, pharmacies, and pharmaceutical manufacturers. They contract with health plans and carriers to administer prescription drug benefits, manage drug costs, and negotiate rebates and discounts from pharmaceutical manufacturers. As relevant here, PBMs create drug formularies––lists of prescription drugs that health plans cover and to which PBMs designate tiers according to how much consumers owe for a co- payment. For example, a tier-1 drug would require a $5 co-payment, while a tier-2 drug would require a $10 co-payment, and so on. Drugs excluded from a PBM’s formulary must be purchased out-of- pocket by consumers, making them a less desirable option in the marketplace. Manufacturers accordingly work to ensure that PBMs include their drugs on formularies. Among other incentives, manufacturers pay rebates—post-sale discounts calculated based on how many

1 For a redacted version of this motion, see ECF No. 32. 2 consumers fill a prescription for the manufacturers’ drug—and other fees to PBMs, which in turn keep a portion of the rebates and fees before passing off the remainder to health insurance plans. Rebates coax PBMs to place drugs on their drug formularies in a preferred tier with a lower cost-share amount, making a drug more attractive for consumers. Gov’t of Puerto Rico v. Express Scripts, Inc., 119 F.4th 174, 180–81 (1st Cir. 2024). Utah alleges that Defendants played a substantial role in causing the opioid epidemic, which has involved “a quadrupling of the number of prescription opioids sold annually in the United States and a tripling of the number of Utahns who died from prescription opioid overdose.” Compl. ¶ 2 (bolding and italics omitted). Through creating and managing national formularies and pharmacy-benefit plans, Defendants shaped consumer access to opioids—affecting “[w]hich opioids would be available” and “[i]n what quantities,” “[w]hat co-payment[s]” and other “authorization” would be required,” and “[w]hat less addictive pain treatments” would be available. Id. ¶ 5. Defendants had extensive data and knowledge about the oversupply of opioids. Id. ¶¶ 6–11. But they failed to take any measures to “slow the dangerous deluge of opioid prescribing” and instead “deliberately chose to facilitate the increased sale and consumption of opioids in exchange for payments from opioid manufacturers.” Id. ¶¶ 11–12. Utah further claims that “Defendants actively collaborated with . . . manufacturers to create, support, and propagate misleading marketing strategies to increase opioid sales.” Id. ¶ 202. Based on these factual allegations, Utah asserts two legal theories. First, it brings a public nuisance claim, alleging that Defendants “maintained a public nuisance though their ongoing unreasonable conduct of facilitating and encouraging the use of dangerously addictive opioids.” Id. ¶¶ 377–410. Second, it brings a claim under the Consumer Sales Practices Act (“CSPA”), Utah Code Ann. §§ 13-11-1 to -23, alleging that Defendants engaged in prohibited “deceptive trade 3 practices.” Compl. ¶¶ 411–23. On these grounds, Utah seeks declaratory, injunctive, and monetary relief. Id. at 97–98. At the same time, Utah’s complaint narrows the scope of its claims to exclude Defendants’ work with the federal government. Id. ¶¶ 361–67. Express Scripts contracts with (1) the

Department of Defense to service healthcare plans for military service members under TRICARE and (2) the Office of Personnel Management (“OPM”), albeit indirectly, to “provide[] services for federal employees enrolled in plans under” the Federal Employees Health Benefits Act of 1959 (“FEHBA”), 5 U.S.C. §§ 8901–14. Notice of Removal at ¶¶ 20–37. And Optum contracts with the U.S. Department of Veteran Affairs (“VA”) to service federal healthcare plans for veterans. Id. ¶¶ 38–49. Utah “specifically exclude[s]” this work for federal healthcare plans from the “allegations in [its c]omplaint.” Compl. ¶ 361. Other provisions go even further, excluding any “conduct related to the provision of any services” under contracts with federal agencies. Id. ¶ 364 (emphasis added). In total, there are seven paragraphs that remove conduct with a connection to the federal government from the allegations of the complaint and the relief sought, which the

parties refer to collectively as the “disclaimer.” Id. ¶¶ 361–67; Notice of Removal ¶ 4; Pls.’ Mot. at 3. Removing Defendants—which are a combination of Express Scripts and Optum entities— jointly filed a notice of removal, with the consent of the remaining defendants. Notice of Removal. They argue that removal is proper and that this court has subject matter jurisdiction “under the federal officer removal statute, 28 U.S.C. § 1442(a)(1), because [Utah] seeks to hold . . . Removing Defendants liable for actions they performed at the direction of federal officers.” Id. ¶ 3. Specifically, they cite Express Scripts’ services for TRICARE and FEHBA plans and Optum’s

4 services for VA plans. ¶¶ 20–49. In doing so, they argue that “[Utah’s] disclaimer is illusory and ineffective.” Id. ¶¶ 62–74. Utah brings its motion to remand to state court on the grounds that Removing Defendants have failed to establish jurisdiction under the officer removal statute. Pls.’ Mot. It contends that its

disclaimer is effective and, consequently, Removing Defendants fail to establish the elements for application of the officer removal statute. Id.; ECF No. 46 (“Pls.’ Reply”). Removing Defendants continue to assert the legal theories raised in their notice of removal. ECF No.

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State of Utah and Division of Consumer Protection v. Express Scripts, Inc., Express Scripts Administrators, LLC, ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy, Inc., ESI Mail Order Processing, Inc., Medco Health Solutions, Inc., UnitedHealth Group, Inc., OptumRx Inc., OptumInsight Life Sciences, Inc., and OptumInsight, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-of-utah-and-division-of-consumer-protection-v-express-scripts-inc-utd-2026.