Mississippi Today
OptumRx sues Mississippi Board of Pharmacy, alleges due process violation
A lawsuit filed by a major pharmacy benefit manager in December alleges the Mississippi Board of Pharmacy violated the company’s right to due process by releasing the findings of an audit before determining any wrongdoing.
The audit’s findings, released by the Board of Pharmacy in October, indicate that OptumRx may have violated Mississippi law by paying independent pharmacies in Mississippi rates lower than chains and Optum-affiliated pharmacies for the same prescription drugs in 2022.
Mississippi law prohibits pharmacy benefit managers from reimbursing their affiliate pharmacies, or those they own, at higher rates than non-affiliate pharmacies for the same services.
OptumRx filed the complaint in Hinds County Chancery Court on Dec. 10, naming all seven Board of Pharmacy members and Executive Director Susan McCoy as defendants. The lawsuit asks the judge to rule that an independent hearing officer preside over the administrative hearing on the audit’s findings.
Administrative hearings can lead to disciplinary action by the Board of Pharmacy, including fines.
A “one-sided press release” issued by the Board of Pharmacy – a two-page document summarizing the 848-page audit completed by Ridgeland-based HORNE accounting firm – thwarted OptumRx’s right to a fair and impartial hearing and demonstrated the board’s bias against the company, said the lawsuit.
The press release did not note the company’s upcoming administrative hearing to determine whether it had violated Mississippi law or state that OptumRx disputes the board’s claims.
An administrative hearing on the alleged law violations was previously scheduled for Dec. 19 but has been delayed due to the lawsuit.
The board declined to provide an independent hearing officer to oversee the administrative proceedings or to remove the press release from their website. It said it would “entertain” the possibility of posting a rebuttal from OptumRx, according to the lawsuit.
OptumRx declined to comment on the lawsuit, but a spokesperson for the company previously told Mississippi Today that it has identified errors in the audit’s findings and methodology and submitted them to the Board of Pharmacy.
The Board of Pharmacy declined to comment on ongoing litigation or administrative hearing matters, and HORNE did not respond to Mississippi Today by the time this story published.
OptumRx argued that the audit’s methodology was unfair because it did not investigate the services provided by affiliated, chain and independent pharmacies and instead assumed that all pharmacies dispensing the same prescription drugs offer identical services.
“It is wholly inappropriate to assume parity of service offerings between different types of pharmacies, such as OptumRx’s affiliated (long-term care) pharmacy and retail pharmacy,” wrote the lawsuit.
The audit’s analysis of a generic drug used to treat bacterial infections alleged that an Optum-affiliated pharmacy was paid eight times more than the lowest-paid independent pharmacy on the same day. Chain and affiliate pharmacies were allegedly paid over 20 times as much as independent pharmacies for a generic drug used to treat stomach and esophagus problems.
The audit’s findings have already led to litigation against the company.
In November, Valley Drugs, Inc., a Water Valley pharmacy, filed a class action federal lawsuit against OptumRx and its parent company, UnitedHealth Group, seeking damages for alleged violations of Mississippi’s prescription drug reimbursement regulation and citing the audit’s findings.
OptumRx is owned by health care behemoth UnitedHealth Group Inc., the U.S.’ most profitable health care company and the owner of the nation’s largest health insurance company, UnitedHealthcare. In 2023, the company brought in $32.4 billion in earnings.
OptumRx is the third-largest pharmacy benefit manager in the nation, representing 22% of the industry’s market share in 2023.
A Federal Trade Commission report in July found that in general, large pharmacy benefit managers pay their own, affiliated pharmacies significantly more than other pharmacies and set reimbursement rates at untenably low levels for independent drug stores.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
‘Fragile and unequipped’: Disproportionate number of Mississippi mothers died preventable deaths during COVID
Mississippi women died of pregnancy complications at nearly twice the national rate during the COVID-19 pandemic, new data shows. The vast majority of those deaths were preventable, according to the latest Mississippi Maternal Mortality Report.
Between 2017 and 2021, 202 women who were either pregnant or up to one-year postpartum died. Seventy-seven of those deaths were directly related to pregnancy.
Black women were five times more likely to die from a condition or circumstance related to pregnancy, the report found.
“Unfortunately, COVID unmasked and exacerbated an already prevalent problem here in Mississippi,” said Lauren Jones, co-founder of Mom.ME and a member of the Maternal Mortality Review Committee members who contributed to the report.
The federally mandated committee, made up of physicians, advocates, social workers and others, is tasked with reviewing all pregnancy and postpartum-related deaths to determine the circumstances that caused them and whether they were preventable. The committee makes recommendations based on what members learn from reviewing the data.
The committee’s first recommendation to reduce these deaths is for the state to expand Medicaid as 40 other states have done.
“The report sheds light on exactly how fragile and unequipped we are to handle what is considered routine maternal care without adding a national health crisis to an already fractured system,” Jones said.
Study authors found that had COVID-19 not happened, it’s “highly likely” that the five-year pregnancy-related mortality rate would have gone down. Instead, it averaged 42.4 maternal deaths per 100,000 live births, peaking at 62.6 in 2021 – compared to a U.S. average of 33.2 the same year at the height of the pandemic. COVID-19 was a leading cause of these deaths, second to cardiovascular conditions.
Nearly half of the women who died because of a pregnancy complication or cause in this time period never received a high school diploma. And nearly three-quarters of them were on Medicaid.
The pregnancy-related mortality rate was highest in the Delta.
A vast majority – 83% – of pregnancy-related deaths were deemed preventable. Committee members made several recommendations, including expanding Medicaid, training all health care providers on blood pressure monitoring, cultural sensitivity and screening for mental health issues.
“I want to acknowledge the Mississippi women who lost their lives in 2017-2021 while pregnant or within a year of pregnancy,” State Health Officer Dr. Daniel Edney said in a statement published in the report. “I extend my heartfelt condolences to their surviving loved ones, and am optimistic that once we know better, we will do better.”
This report comes at the heels of the 2022 Infant Mortality Report, which showed that Mississippi continues to lead the nation in the number of infants who die before their first birthday. However, the number of infant deaths attributed to Sudden Infant Death Syndrome, or SIDS, decreased by 64% between 2021 and 2022.
Edney also commended the Maternal Mortality Review Committee members who he said “tirelessly leave no question unasked and no stone unturned in exploring what happened and how these deaths might have been prevented.”
In 2024, the committee met six times to review 54 maternal deaths from 2021.
“No one wants to serve on a committee that is only established to review death. It’s mentally and emotionally hard, but as members we do it not only to lend our personal expertise in determinations but to be a voice for those lost in hopes of sparking necessary change for better outcomes,” Jones said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Crooked Letter Sports Podcast
Podcast: Putting a wrap on the Saints and Rebels, and lots more
Following a holiday break, the Clevelands put a lid on the Ole Miss and New Orleans Saints football seasons. Also in the discussion are Southern Miss’s 25-player haul in the transfer portal, including 16 from Marshall. Rick also gives his memories of Magnolia State football heroes Jerald Baylis and Dontae Walker.
Stream all episodes here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Mississippi is ‘A Complete Unknown’ in Bob Dylan biopic
The new film, “A Complete Unknown,” tells the story of Bob Dylan’s rise to success in the early 1960s, but the movie leaves out two fascinating Mississippi stories.
On the evening of June 11, 1963, President John F. Kennedy delivered his first civil rights speech in which he declared that the grandchildren of enslaved Black Americans “are not fully free. They are not yet freed from the bonds of injustice. They are not yet freed from social and economic oppression. And this Nation, for all its hopes and all its boasts, will not be fully free until all its citizens are free.”
Hours later, Mississippi NAACP leader and World War II veteran Medgar Evers was fatally shot in the back outside his home in Jackson.
Less than a month later, Dylan (portrayed in the movie by Timothée Chalamet) unveiled a new song in a cotton field several miles south of Greenwood, where Evers’ assassin, Byron De La Beckwith, lived.
That field happened to be owned by Laura McGhee, the sister of Gus Courts, who was forced to flee Mississippi after surviving an assassination attempt in 1955. Her three sons, Clarence, Silas and Jake, took part in protests that helped integrate the Leflore Theatre in Greenwood. Her house was shot into and firebombed, but she and her sons kept on fighting.
Dozens of Black Americans listened as they parked under umbrellas to block out the blazing sun while Dylan debuted the song, a scene that Danny Lyon captured in photos.
As he strummed chords, he told those gathered, “I just wanted to sing one song because I haven’t slept in two nights, and I’m a little shaky. But this is about Medgar Evers.”
His shakiness showed. He had to restart once before continuing.
Titled “Only a Pawn in Their Game,” Dylan’s song focused on how Evers’ assassin and other poor white Mississippians are nothing more than a pawn in the white politicians’ “game.”
A South politician preaches to the poor white man
“You got more than the blacks, don’t complain
You’re better than them, you been born with white skin,” they explain
And the Negro’s name
Is used, it is plain
For the politician’s gain
As he rises to fame
And the poor white remains
On the caboose of the train
But it ain’t him to blame
He’s only a pawn in their game
In the final verse, Dylan spoke about the civil rights leader.
Today, Medgar Evers was buried from the bullet he caught
They lowered him down as a king
But when the shadowy sun sets on the one
That fired the gun
He’ll see by his grave
On the stone that remains
Carved next to his name
His epitaph plain
Only a pawn in their game
Dylan also sang, “Blowing in the Wind,” which Peter, Paul and Mary had just turned into a top hit.
Dylan’s mentor, Pete Seeger (portrayed in the movie by Edward Norton) also performed at this music festival organized by the Student Nonviolent Coordinating Committee, which had been fighting to register Black Mississippians to vote.
Dylan returned to New York City. During the day, he would hang out at the SNCC office, recalled civil rights leader Joyce Ladner. “He would get on the typewriter and start writing.”
She and her sister, Dorie, were no strangers to the civil rights movement. They had been expelled from Jackson State University in 1961 for taking part in a silent protest in support of the Tougaloo College students arrested for integrating the downtown Jackson library.
Now attending Tougaloo, the sisters helped with preparations for the March on Washington for Jobs and Freedom. After working days at the SNCC office, they would spend nights at the apartment of Rachelle Horowitz, the march’s transportation coordinator.
Each night, they arrived at about 11 p.m., only for Dylan to sing his new songs to Dorie until well past midnight, Ladner said.
That annoyed her because she was trying to get some sleep. Each night when they arrived, “we could hear him from the elevator,” she said. “I thought, ‘Oh, God, not him again.’”
At the August 1963 march, Dylan performed the two same songs he sang in that Delta cotton field, as well as others, this time before a crowd of more than 250,000. Folk singer Joan Baez (portrayed in the movie by Monica Barbaro) harmonized.
Not long after that performance, Ladner said Dylan visited Dorie at Tougaloo and once again sang her some of his songs before he said that he and the others “had to be going. They were driving down Highway 61.”
That highway connects Dylan’s birthplace of Duluth, Minnesota, to the Mississippi Delta. In 1965, Dylan released “Highway 61 Revisited,” generally regarded as one of the best albums of all time.
Dylan moved on, but Ladner said Dylan never forgot her sister, Dorie, a major civil rights figure who passed away last year.
“Whenever he performed in Washington, D.C., she would hang out backstage with him and the guys,” Ladner recalled. “That went on for years.”
She said she believes Dylan penned “Outlaw Blues” about her sister.
I got a girl in Jackson, I ain’t gonna say her name
I got a girl in Jackson, I ain’t gonna say her name
She’s a brown-skin woman, but I love her just the same.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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