SANTA FE, N.M. (Legal Newsline) — Express Scripts faces a lawsuit from the entity handling insurance for public school employees in New Mexico.
New Mexico Public Schools Insurance Authority filed a complaint Oct. 20 in Santa Fe state court against Express Scripts Inc., alleging violations of the Unfair Practices Act and other claims. The defendant removed the case to federal court on Nov. 21.
According to its complaint, the New Mexico Public Schools Insurance Authority entered into a pharmaceutical benefits management services agreement with Express Scripts in July 2018. It claims Express Scripts has breached their contract by underpaying the minimum rebate guarantees by $2,975,148.
It further claims Express Scripts excluded from the rebate guarantees the "Dispense as Written code," for which it pays a generic drug cost and the member is billed the difference. Specifically, the plaintiff claims Express Scripts underpaid the "average wholesale price discount guarantees" by a total of $1,612,535 between January and June of 2020.
The plaintiff seeks monetary relief, interest and all other just relief. It is represented by Martin Esquivel of Esquivel & Howington LLC in Albuquerque and Charles Purcell of Rodey, Dickason, Sloan, Akin & Robb PA in Albuquerque.
U.S. District Court for the District of New Mexico case number 1:23-CV-01034-SCY-GBW