News from the South - West Virginia News Feed
Optum Rx invokes open meetings law to fight Kentucky counties on opioid suits
by Aneri Pattani, KFF Health News, West Virginia Watch
August 25, 2025
UnitedHealth Group’s multibillion-dollar pharmacy benefit manager, Optum Rx, is suing five Kentucky counties in an attempt to force them out of national opioid litigation against the company.
Pharmacy benefit managers, often called PBMs, act as middlemen that negotiate prescription drug prices between drug companies, insurance plans, and pharmacies. Some lawyers and advocates say PBMs helped fuel the overdose crisis by failing to restrict the flow of opioid prescriptions.
As governments begin exploring potential lawsuits against PBMs — a step that could represent the next wave in opioid-related litigation — Optum Rx is attempting to shut down those efforts, in some cases before they even fully take shape.
In June, Optum Rx sued Anderson, Boyd, Christian, Nicholas, and Oldham counties in Kentucky for allegedly making decisions about participating in the new wave of national opioid lawsuits behind closed doors, violating Kentucky’s open meetings law. Optum Rx is asking courts to effectively force those counties to make their decisions again, this time in open meetings, potentially with the hope that some won’t bother because of the administrative burden. The result could be fewer claims against the company and possibly less money for it to pay in a future settlement.
But legal experts call Optum’s case “hypertechnical” and “frivolous,” and addiction recovery advocates say it could set a dangerous precedent for companies to evade accountability for their role in fueling the overdose crisis.
Christine Minhee, an attorney, a national expert on opioid litigation, and founder of OpioidSettlementTracker.com, said Optum’s suit reminded her of an adage among lawyers: “If the facts are on your side, pound the facts. If the law is on your side, pound the law. If neither is on your side, pound the table.”
“Right now, what we’re seeing is it pounding the table,” Minhee said of Optum Rx. The company is “desperately” trying “to find some kind of foothold” to get cases against it thrown out.
Minhee said these suits fit a pattern of Optum Rx using thin arguments to try to delay or evade opioid litigation nationwide.
Last year, Optum Rx, along with another PBM, asked a judge to throw out an opioid lawsuit filed by Los Angeles County, claiming during a December hearing that the county hadn’t shown harm. The judge appeared skeptical of the claims and ultimately rejected the companies’ request.
In April, the same companies tried to oust a federal judge overseeing national opioid litigation, claiming he was biased. Their argument was based partly on a Florida lawyer’s having said the judge was “plaintiff-oriented.” Their attempt failed.
Now, Optum Rx is working to keep five Kentucky counties out of that same sweeping opioid litigation.
That national legal undertaking began more than seven years ago, as jurisdictions saw overdose deaths climb. Many people who had become addicted to prescription painkillers were cut off by their doctors, and some transitioned to using deadlier heroin or fentanyl. Health care and public safety costs skyrocketed. Thousands of cities, counties, and states began suing health care companies for allegedly creating a public nuisance by aggressively marketing prescription painkillers and negligently distributing them.
Those cases were lassoed together into the giant multidistrict litigation, which has resulted in massive settlements. The first few waves of settlements involved opioid manufacturers, distributors, and retail pharmacies, with companies such as Johnson & Johnson, CVS, and Walgreens agreeing to pay state and local governments billions of dollars. The money is meant to be used for addiction treatment and prevention services — though its rollout has been controversial.
To add a new round of companies as defendants, jurisdictions must undertake a multistep process, said Peter Mougey, a Florida-based attorney who represents many local governments in the massive national litigation. The five Kentucky counties in question were in the early stages of that process, only having asked the judge to amend their complaint, he said. They hadn’t added Optum Rx yet.
If Optum Rx’s suits are successful, those counties would have the option of redoing the initial steps of the process in a public meeting, then continuing to add Optum Rx as a defendant, Mougey explained. The company may hope that some counties won’t undertake the extra administrative effort.
Optum Rx’s “goal is clearly just to wear down and tire out these small counties,” Mougey said. “They’re trying to have a chilling effect on the litigation.”
It’s not clear why Optum Rx targeted those five counties out of the many localities undertaking the process to add the company as a defendant. The Kentucky counties range from having fewer than 8,000 residents (Nicholas) to more than 70,000 (Christian). One is among the richest in Kentucky (Oldham), while others are poorer. Boyd County, in Appalachia, is one of the hardest hit, with a recent overdose rate twice the state average.
Optum Rx, in its filing against Boyd County, which was similar to claims against the other counties, said local authorities had taken official legal action by asking the judge to make a change in its case. The suit said such action must be done in a public meeting and that the county did not hold one.
Optum spokesperson Isaac Sorensen told KFF Health News that the company’s argument is not about “a technicality.”
It is “an important legal requirement designed to ensure accountability and transparency before a county takes legal action,” said the statement Sorensen provided. “We have found many counties ignored this requirement, alongside their duty to preserve relevant evidence, and Optum Rx will defend against these improper legal actions.”
The five Kentucky counties disagree with these assertions, according to court records. As of late July, all five had filed motions to dismiss Optum Rx’s claim.
Boyd County, like the others, argued in its motion to dismiss that asking a judge to amend its complaint was a routine, procedural step that did not require a public meeting. Optum Rx jumped the gun, the county argued, filing a case before any final action had been taken.
“No amended complaint has been filed. No new defendant, OptumRx included, has been added. No new lawsuit has been initiated,” Boyd County’s response said.
The county also pointed out that it held an open meeting in 2017 that kicked off its involvement in the national litigation and authorized future amendments to that litigation.
Hearings on the counties’ motions to dismiss Optum Rx’s suits are set for late August and early September, according to court records.
These cases are shaping up to be a Goliath-versus-David legal action. Although Oldham County is the wealthiest of the Kentucky counties that Optum Rx sued, its most recent budget is less than 0.1% of Optum Rx’s annual revenue, which the company reported as exceeding $133 billion in 2024.
Oldham County Attorney D. Berry Baxter told KFF Health News he’d seen the impact of the opioid epidemic as a prosecutor working on a growing number of drug-related cases over the years. Now, as settlement money is arriving from other companies, it has funded increased addiction treatment in local jails. More settlement money from additional companies could expand such services, Baxter said.
If Optum Rx succeeds in kicking Kentucky counties out of the national litigation, it would set “a really horrific precedent” for other PBMs and health care companies to do something similar, said Tara Hyde, CEO of the statewide nonprofit People Advocating Recovery.
Hyde said she’s been in recovery for more than a decade from an addiction that began with prescription painkillers for a broken leg. She wants to see PBMs and other companies held accountable and made to change their processes to prevent future crises.
Despite a recent decrease in overdose deaths nationwide, Hyde said people in her state, their families, and the economy are still hurting.
“Recovery doesn’t just happen overnight,” she said. “Without these dollars that have been a direct result of people being misled, mistreated, and taken advantage of, we will still be detrimentally impacted.”
This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.
The post Optum Rx invokes open meetings law to fight Kentucky counties on opioid suits appeared first on westvirginiawatch.com
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
This content leans center-left as it emphasizes corporate accountability, particularly targeting large healthcare companies and pharmacy benefit managers for their role in the opioid crisis. It highlights the struggles of affected communities and advocates for transparency and justice through legal action. The article supports regulatory and legal interventions to address public health issues, reflecting a perspective that favors government and community efforts to hold powerful entities responsible, which is characteristic of center-left viewpoints.
News from the South - West Virginia News Feed
Rock Hill rolling into 2025 with hunger to win
SUMMARY: Rock Hill High School, led by head coach Tony Love in his 32nd year, is gearing up for the 2025 football season with determination to win. After hosting a playoff game last year and advancing two rounds, the team is older, stronger, and hungrier. Emphasizing hard work, discipline, and mental toughness, the players have trained rigorously through winter. The offensive and defensive lines are crucial, handling the tough, physical battles on the field. This young but battle-tested squad is ready to start their season opener on the road, aiming to build on last year’s postseason experience and achieve greater success.
Football season is here and Rock Hill is ready to rock-and-roll on the gridiron. This team hosted a playoff game last year and was …
News from the South - West Virginia News Feed
WEEKEND WEATHER AUG 24TH
SUMMARY: WEEKEND WEATHER AUG 24TH: Today was a pleasant, typical summer day with temperatures reaching 80° in Beckley. A cold front is moving through tonight, bringing increasingly breezy winds and cooler air, dropping temps to the high 50s overnight and into the 40s early next week. Rain chances remain very low, with mainly dry conditions expected tonight and tomorrow. Monday will feature a mix of clouds and sun with highs in the high 60s to low 70s—cooler than normal. Low humidity and comfortable weather will continue through the week, making it a great time to enjoy the outdoors as fall arrives early.
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News from the South - West Virginia News Feed
Feds direct states to check immigration status of their Medicaid enrollees
by Anna Claire Vollers, West Virginia Watch
August 22, 2025
This week, the Trump administration’s Centers for Medicare & Medicaid Services (CMS) announced an effort to check the immigration status of people who get their health insurance through Medicaid and the Children’s Health Insurance Program.
Medicaid is the public health insurance program for people with low incomes that’s jointly funded by states and the federal government. For families that earn too much to qualify for Medicaid but not enough to afford private insurance, CHIP is a public program that provides low-cost health coverage for their children.
The feds will begin sending states monthly enrollment reports that identify people with Medicaid or CHIP whose immigration or citizenship status can’t be confirmed through federal databases. States are then responsible for verifying the citizenship or immigration status of individuals in those reports. States are expected to take “appropriate actions when necessary, including adjusting coverage or enforcing non-citizen eligibility rules,” according to a CMS press release.
“We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law,” Robert F. Kennedy Jr., who oversees CMS as secretary of the U.S. Department of Health and Human Services, said in a press release announcing the new program.
As of April, roughly 71 million adults and children nationwide have Medicaid coverage, while another 7 million children have insurance through CHIP. Immigrants under age 65 are less likely to be covered by Medicaid than U.S.-born citizens, according to an analysis from health research organization KFF.
Immigrants who are in the country illegally aren’t eligible for federally funded Medicaid and CHIP. Only citizens and certain lawfully present immigrants — green card holders and refugees, for example — can qualify.
But some states have chosen to expand Medicaid coverage for immigrants with their own funds. Twenty-three states offer pregnancy-related care regardless of citizenship or immigration status, according to KFF. Fourteen states provide coverage for children in low-income families regardless of immigration status, while seven states offer coverage to some adults regardless of status.
The tax and spending package President Donald Trump last month cuts federal spending on Medicaid by more than $1 trillion, leaving states to either make up the difference with their own funds or reduce coverage. But the new law also includes restrictions on coverage for certain immigrants, including stripping eligibility from refugees and asylum-seekers.
Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.
West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.
The post Feds direct states to check immigration status of their Medicaid enrollees appeared first on westvirginiawatch.com
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
This article provides a balanced overview of recent policy changes to Medicaid and CHIP enrollment verification tied to immigration status. It presents facts, official statements, and statistics without emotive language or partisan framing. Both the rationale behind the policy, such as safeguarding taxpayer dollars, and the impact on immigrants are covered objectively. The inclusion of context on eligibility rules and varying state approaches reinforces a neutral, informative tone, typical of centrist reporting seeking to inform rather than advocate.
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