Case Caption: Plumbers' Welfare Fund, Local 130 U.A. v. Express Scripts, Inc., et al.
Court: U.S. District Court for the Northern District of Illinois
Case Number: 1:26-cv-01718
Judge: Honorable Martha M. Pacold
Plaintiff: Plumbers' Welfare Fund, Local 130 U.A.
Defendant: Express Scripts, Inc., Evernorth Health Services, and The Cigna Group
Class Period: TBD
Plaintiff asserts claims on behalf of third-party payors that engaged Express Scripts, Inc. (“ESI”) for pharmacy benefit manager (“PBM”) services and alleges that ESI, together with its corporate parents Cigna and Evernorth, orchestrated a fraudulent scheme to retain billions of dollars that should have been passed on to Plaintiff and the Class.
Among the PBM services that ESI historically provided its clients are the design of formularies, which are the lists of drugs covered by a prescription plan, and the negotiation of rebates, which are payments from drug companies that ostensibly reduce the cost of drugs. In 2019, however, the defendants created a group purchasing organization, Ascent Health Services (“Ascent”), to purportedly negotiate with drug companies on behalf of ESI. As alleged in the complaint, the defendants used Ascent to sell formulary access and preferential formulary placement to drug companies in exchange for the drug companies diverting a portion of their rebates to Ascent as exorbitant and misclassified “fees”. These “fees” should have been passed on to Plaintiff and the Class, pursuant to their contracts with ESI, but instead were retained by the defendants. Moreover, these “fees,” which vastly exceed the fair market value of Ascent's services, constitute bribes and kickbacks in exchange for favorable formulary placement. As part of the alleged scheme, the defendants also disseminated false and/or misleading statements to conceal that they were secretly profiting at the expense of PBM customers.
On February 17, 2026, Plaintiff filed a complaint against the defendants, asserting the following claims: (1) Violations of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. § 1962(C)—Racketeering; (2) Violations of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. § 1962(D)—Racketeering Conspiracy; (3) Breach of Contract; (4) Breach of the Implied Covenant of Good Faith and Fair Dealing; and (5) Unjust Enrichment. The defendants filed a motion to dismiss the complaint on April 28, 2026.