Alternative Medicine and Pharmacy, Inc. v. Express Scripts, Inc. et al
MEMORANDUM AND ORDER - IT IS HEREBY ORDERED that plaintiff's motion for preliminary injunction [#16] is denied. IT IS FURTHER ORDERED that defendants' motion for leave to file a supplemental brief [#57] is denied. This case will be referred to mediation by separate Order and will be set for a Rule 16 Scheduling Conference, if necessary, only after mediation is completed. Signed by District Judge Catherine D. Perry on October 7, 2014. (MCB)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
AND PHARMACY, INC.,
EXPRESS SCRIPTS, INC., et al.,
Case No. 4:14 CV 1469 CDP
MEMORANDUM AND ORDER
This matter is before me on plaintiff’s motion for preliminary injunction.
Plaintiff Alternative Medicine and Pharmacy, Inc., d/b/a Omniplus Pharmacy
(Omniplus) brought this suit against defendants Express Scripts, Inc., and Medco
Health Services, Inc. (collectively referred to here as Express Scripts). Omniplus,
who is currently part of Express Scripts’ provider network, sued after Express
Scripts sent notice that it was terminating their contract for cause. Express
Script’s stated reason for the termination was that Omniplus had misrepresented
that it did not waive co-payments. Omniplus contends that it does not waive copayments, and argues that if Express Scripts is allowed to terminate the contract it
will put Omniplus out of business. I will deny the motion for preliminary
injunction for the reasons that follow.
OmniPlus is a community and compounding pharmacy with a mail order
business.2 Express Scripts is a pharmacy benefits manager.3 OmniPlus has a
contract (Provider Agreement) with Express Scripts to provide pharmacy services
to members of health plans managed by Express Scripts. The parties’ relationship
is also governed by a Provider Manual. Approximately 25 percent of OmniPlus’
patients are managed by Express Scripts, and those patients represent about 51
percent of its revenue.
On July 31, 2014, Express Scripts sent a letter to OmniPlus terminating its
membership in Express Scripts’ pharmacy network effective September 1, 2014,
alleging contractual violations and asserting a termination for cause. OmniPlus
disputed the termination with Express Scripts and then filed suit in this Court on
August 25, 2014, alleging breach of the Provider Agreement and violation of
Texas law. OmniPlus sought a temporary restraining order and a preliminary
The facts are set out in this Memorandum and Order for purposes of deciding the
preliminary injunction motion only, and this Memorandum and Order does not relieve
any party of the burden of proving any facts in support of its claims or defenses on
summary judgment or at trial and may not be relied upon for that purpose.
Compounding pharmacies have the ability to mix multiple drugs or active ingredients to
create a medication specifically tailored to a patient’s needs. OmniPlus’ compounding
business is almost exclusively mail order.
Pharmacy benefit managers manage and attempt to reduce pharmacy reimbursement
expenses for member claims on behalf of health plan administrators and third-party
payors such as insurance companies, employers, and health maintenance organizations.
Express Scripts is the largest pharmacy benefit manager in the United States. Express
Scripts also competes with OmniPlus directly in the mail-order pharmacy business.
injunction preventing its termination from the Express Scripts’ pharmacy network.
After the parties entered into a stipulation agreeing that Express Scripts would not
terminate OmniPlus’ Provider Agreement pending the resolution of the preliminary
injunction motion, I denied the motion for temporary restraining order. The parties
conducted limited discovery and the preliminary injunction hearing was held on
September 25, 2014. At the hearing OmniPlus offered one witness, Scott
Breimeister, who has worked for the company for nine months and became
President at the end of August. Express Scripts also offered one witness, John
Gavin, who is a Senior Manager with Express Scripts’ fraud, waste, and abuse
team and participated in the decision to terminate OmniPlus.
Section 2.4 of the Provider Agreement4 states that OmniPlus “shall collect
from Members . . . the applicable Copayment indicated by [Express Scripts]” and
further provides that “[c]opayments may not be waived or discounted . . . .” [Doc.
#38-1 at 3]. The Provider Manual5 explains what will happen to OmniPlus if it
fails to collect co-payments:
All of the documents discussed herein were also introduced as exhibits at the
preliminary injunction hearing. For ease of reference, I will cite to those documents as
they can be found in the Court file unless they are not in the record. In those cases I will
refer to the exhibit designations from the hearing.
In the version of the Provider Manual attached as sealed Exhibit B to Express Scripts’
trial brief [Doc. #38], this Section appears as 2.3. However, in an updated version of the
Provider Manual, which was attached to Express Scripts’ memorandum in opposition to
the renewed motion for temporary restraining order, this Section appears as 2.2. [Doc.
#25-2 at 6]. For convenience, I will hereafter refer to the Section as 2.3.
Network Provider may not institute Member copayment discount
program or otherwise alter a Member Copayment, unless such waiver
or discount is required by law. If [Express Scripts] becomes aware of
any copayment or cost-sharing discounts being offered by Network
Provider – either through audit, investigation, Member statements , or
review of Network Provider’s website or other advertising materials –
Network Provider may be subject to immediate termination. For
clarification, if [Express Scripts] identifies fliers, advertisements, or
other statements from Network Provider suggesting that copayments
will be a flat fee or that copayments will be discounted, capped, or
waived will result in termination of Network Provider.
The Provider Agreement provides Express Scripts with an immediate right
to terminate OmniPlus from the provider network in the event that:
1. OmniPlus “fails to comply with [Express Scripts’] policies and
procedures, including, but not limited to, the Provider Manual”;
2. OmniPlus “fails to comply . . . with Section 2.4 of this Agreement
[dealing with copayments]; or
3. OmniPlus “no longer meets credentialing requirements.”
[Doc. #38-1 at 4]. The Provider Manual contains a similar provision, except it also
includes a right to immediate termination upon notice if “any representation to
[Express Scripts] or any response to a question set forth on the Provider
Certification is untrue or becomes untrue,” or if OmniPlus “breaches any of its
representations and warranties set forth in this Agreement or any other document
provided to OmniPlus.” [Doc. #25-2 at 4]. Section 4.2 of the Provider Agreement
permits Express Scripts to terminate OmniPlus without cause upon 90 days written
The Provider Manual also includes a Texas-specific addendum. Section 5 of
the addendum provides in relevant part as follows:
5.1 [Express Scripts] shall provide a written explanation to [OmniPlus]
of the reason(s) for termination at least ninety (90) days prior to the
effective date of such termination to the extent required by law. On
request . . . and before the effective date of the termination, and within
at most sixty (60) days of request, [OmniPlus] shall be entitled to such
review and formal, though non-binding, recommendation from
[Express Scripts] in accordance with, and to the extent required by, 28
T.A.C. 3.3703(a)(19), except . . . in a case of fraud or malfeasance.
5.2 Any notice of termination by [Express Scripts] shall include
[OmniPlus’] right to request, within thirty (30) days of receipt of the
termination notice, a review by insurer in accordance with, and to the
extent required by 28 T.A.C. § 3.3706(h), 3.9204(g), Tex. Admin.
[Doc. #1-3 at 1].
Threshold credentialing is required for membership in Express Scripts’
pharmacy provider network, as is periodic re-credentialing. The credentialing
process relies, in part, on Provider Certifications, which must be completed by
would-be and existing pharmacy provider network members. Provider
Certifications include questions concerning the type of services a pharmacy offers,
pharmacist discipline, and general pharmacy business practices. By submitting a
The Provider Agreement actually says “30 days . . . or longer . . . as may be required by
law,” but Express Scripts concedes for purposes of this motion that the Texas-specific
Addendum would appear to require 90 days written notice of a termination without cause.
Provider Certification, a pharmacy such as OmniPlus certifies that the information
provided is “true and correct” and agrees to “notify Express Scripts immediately in
writing” if any part of the certification becomes “untrue or inaccurate.” A
pharmacy also agrees that the failure to notify Express Scripts of any change in its
Provider Certification “will be considered a breach of my Provider Agreement and
could result in disciplinary action including, but not limited to, immediate
termination of my Provider Agreement.”
In the spring of this year Express Scripts required OmniPlus to complete a
Provider Certification form, which OmniPlus submitted on March 4, 2014.
Question # 29 asked whether “you or your pharmacy(ies) ever waive or offer a
reduction of member copayments”? OmniPlus answered, “No.” Mr. Gavin
testified that this was the first time that OmniPlus had ever been asked this
question, which was one of several additional questions that were submitted to all
compounding pharmacies. A complete copy of the Provider Certification was
introduced at the hearing as defendants’ Exhibit G. In this document, OmniPlus
also certified that 98 % of its business was “open door retail/community,” while
only two percent was mail order. OmniPlus also stated that five percent of its
business was in compounding. In contrast, Mr. Breimeister testified that the mail
order and compounding businesses were essentially the same, and were a
“significant” part of OmniPlus’s business.
After receiving the certification form, Express Scripts contacted some
members who used OmniPlus’ mail-order delivery service and asked these
members whether they had paid the required co-payments for these prescriptions.
One member told Express Scripts that he was informed by OmniPlus that
OmniPlus “would send an invoice but wouldn’t try to collect,” so that member did
not fill his prescription with OmniPlus. Three other members filled prescriptions
using OmniPlus’ mail-order pharmacy in March, but had not received bills for their
co-payments as of May 29, 2014.7 Based on this information, Express Scripts
notified OmniPlus that it was being terminated for cause for failing to collect
In response to the termination notice, OmniPlus protested that it collected
member co-payments and sought internal review of the termination decision under
Texas law, which OmniPlus insists applies on its own terms and because it is
incorporated into the parties’ agreement by virtue of a Texas-specific addendum to
the Provider Agreement. Express Scripts declined to provide any internal review
At the preliminary injunction hearing, OmniPlus argued that it has never
waived copayments for Express Scripts’ members and that it collects copayments
in accordance with their Provider Agreement. It introduced an exhibit containing a
Express Scripts discovered five more instances of OmniPlus’ failure to collect copayments for prescriptions invoiced between May 2, 2014 and July 25, 2014.
number of screen shots from its computer system showing that customers had paid
co-payments. Plf. Exh. 14. Express Scripts, on the other hand, introduced account
statements showing Express Scripts patients who had been invoiced for
copayments in the thousands of dollars, yet had failed to pay any portion of the
copayments even though the original invoices had been issued several months ago.
Deft. Exh. A2, B2, C2, D2. Mr. Breimeister testified that the OmniPlus documents
“show we invoice and attempt to collect on every prescription we fill.”
The parties also dispute the meaning of two documents produced by
OmniPlus during discovery. Express Scripts contends they show that OmniPlus
waives co-pays, and OmniPlus contends they show the opposite. One is a written
policy and procedure for co-pay collection dated July 31, 2014. Deft. Exh. W.
With regard to commercial insurance patients, it states that OmniPlus invoices
patients, but “will work with them and accept any installment payment plan they
can afford,” and “will not turn them over or report to collection agencies.” It then
goes on to say people can complete an application for copayment waiver, and sets
out the criteria for granting waivers. The other is an October 8, 2013 protocol
applicable to patients seeking a particular compounded medication. Plf. Exh. 6. It
directs employees to tell patients who ask about co-payments that “per our contract
with the insurance companies, we do have to send you an invoice and bill you.” It
goes on to direct telling patients that OmniPlus “can never waive a co-payment,
which is illegal.”
OmniPlus says the waiver provision merely tracks Medicare regulations.
Express Scripts argues that the documents show that OmniPlus apparently believed
it was only obligated to invoice and bill for co-payments, not to collect them. Mr.
Breimeister testified that OmniPlus never waives copayments, but he
acknowledged that it makes no effort to pursue unpaid copayments through
collection agencies, claiming that it was not company policy and that it did not
have the resources to do so. He did not know whether OmniPlus made any other
attempts to collect, such as sending follow-up or past due invoices. He could not
explain why the various account records introduced into evidence showed all
amounts due as “current” and none as past due, even when the invoices were sent
months ago and still not paid.
Express Scripts maintains that it can no longer trust OmniPlus and that the
relationship between the parties is over.
OmniPlus argues that the loss of membership in Express Scripts’ network
could put it out of business. In support of that argument, OmniPlus offered the
testimony of Mr. Breimeister, who has only been with Express Scripts for nine
months and President since last month. Mr. Breimeister claims that OmniPlus
would be “out of business in a very short time” if its network membership is
terminated because physicians writing compounding prescriptions “do not have
time” to ask patients what their insurance plan is and may therefore find it easier to
send all their prescriptions, not just ones for Express Scripts members, to a
competing pharmacy. Mr. Breimeister, however, offered no foundation for this
testimony and OmniPlus offered no evidence, such as physician affidavits or
statements, to support this speculative contention. Mr. Breimeister also did not
testify that the mere loss of its Express Scripts’ business on its own – without this
alleged “added” harm of losing its non-Express Scripts compounding business –
would force OmniPlus to close its doors. OmniPlus also offered no evidence
regarding its total revenues; Mr. Briemeister said the mail order and compounding
business was a “significant” portion of its business, although the form sent in this
spring said it was no more than 5% .
Preliminary Injunction Standard
“The primary function of a preliminary injunction is to preserve the status quo
until, upon final hearing, a court may grant full, effective relief.” Kansas City So.
Trans. Co., Inc. v. Teamsters Local Union # 41, 126 F.3d 1059, 1066 (8th Cir.
1997) (citation omitted). “A plaintiff seeking a preliminary injunction must
establish that he is likely to succeed on the merits, that he is likely to suffer
irreparable harm in the absence of preliminary relief, that the balance of equities
tips in his favor, and that an injunction is in the public interest.” Winter v. Natural
Res. Def. Council, Inc., 555 U.S. 7, 20, 129 S. Ct. 365, 374 (2008). In the Eighth
Circuit, these four factors are known as the “ Dataphase ” factors, based upon the
1981 en banc case, Dataphase Sys., Inc. v. C L Sys., Inc., 640 F.2d 109, 113 (8th
Cir. 1981). In each case, the factors must be balanced to determine whether they
tilt toward or away from granting injunctive relief. West Pub. Co. v. Mead Data
Cent., Inc., 799 F.2d 1219, 1222 (8th Cir. 1986). The party requesting injunctive
relief bears the “complete burden” of proving that an injunction should be granted.
Gelco Corp. v. Coniston Partners, 811 F.2d 414, 418 (8th Cir. 1987). Injunctive
relief is “an extraordinary remedy that may only be awarded upon a clear showing
that the plaintiff is entitled to such relief.” Winter, 555 U.S. at 22.
Both sides came up with new arguments at the preliminary injunction
hearing. Express Scripts argued that OmniPlus is obligated to collect co-payments
under the Provider Agreement, not just invoice for them, and that this constitutes a
further breach of the Provider Agreement justifying termination. For the first time
at the hearing, Express Scripts argued that the failure to collect a copayment
amounts to a waiver or discount of a copayment. OmniPlus argued, for the first
time, that despite the language of the Provider Agreement allowing termination for
any reason with appropriate notice, Texas law prevents any termination except for
At the preliminary injunction stage, OmniPlus must establish a substantial
likelihood of prevailing on the merits of its claims. Planned Parenthood Minn.v.
Rounds, 530 F.3d 724, 732 (8th Cir. 2008). As for the first Dataphase factor,
whether Express Scripts terminated OmniPlus for cause, whether either party
breached the Provider Agreement, and whether OmniPlus is entitled to any review
procedures or remedies under Texas law are complex and hotly contested factual
disputes, and this Court has no way at this juncture to predict which side is likely
to prevail at trial. On the breach of contract claim, Express Scripts has come
forward with some evidence suggesting that OmniPlus may have at least breached
the Provider Agreement and/or Provider Manual by failing to collect some high
dollar copayments for compounded medications in its mail-order business. Of
course, this is not the precise reason given for termination in the July 31, 2014,
termination letter. Whether the failure to collect a copayment amounts to a waiver
or discount of a copayment under the parties’ agreement and whether Express
Scripts may properly rely on the breach of one provision of its agreement to justify
termination when it originally relied on another is not clear and cannot be decided
on the limited record presented at the preliminary injunction hearing.
For its part, OmniPlus has poked numerous holes in Express Scripts’ stated
reasons for termination, suggesting that the proffered reasons for termination are
baseless and essentially a “moving target” orchestrated to eliminate OmniPlus as a
direct competitor in the mail-order compounding pharmacy business. For
example, Mr. Gavin conceded that OmniPlus’ alleged waiver policy was consistent
with Medicare regulations allowing limited exceptions in cases of extreme
financial hardship. OmniPlus also presented evidence that it has never had a
request for waiver under this policy. As for the only Express Scripts’ member
surveyed who actually claimed that he was told by OmniPlus that it “would send
an invoice but wouldn’t try to collect,” that member did not actually fill his
prescription with OmniPlus. Mr. Breimeister testified that situation actually
occurred frequently with the mail-order compounding business once patients were
informed of the amount of the copayment, which could be in the thousands of
dollars. OmniPlus argues that this factor demonstrates that they do not waive
copayments, and it also points out the protocols for customer service
representatives to actually inform members that they do not offer waivers or
discounts and are required by law to charge for copayments. The Court cannot
predict at this juncture which side will be able to prevail on the breach of contract
claim at trial.
OmniPlus has offered far less to demonstrate that it is likely to prevail on the
merits of its claim for breach of Texas insurance law. Even if OmniPlus clears the
first hurdle of demonstrating that the relied-upon provisions of Texas law apply to
Express Scripts, it has offered nothing demonstrating that it has a private right of
action under the statute. The sole case cited by OmniPlus on this issue, Coll v.
Abaco Operating LLC, 2011 WL 1831748 (E.D. Tex. May 12, 2011), does not
stand for the proposition that OmniPlus has a private right of action here. That
case does not even deal with insurance law, but instead discusses whether an
implied right of action exists for certain provisions of the tax code.
I need not resolve these issues, however, as I find that the motion must be
denied because OmniPlus has not demonstrated that it is likely to suffer irreparable
injury in the absence of injunctive relief. “The threshold inquiry is whether the
movant has shown the threat of irreparable injury.” Modern Computer Sys., Inc. v.
Modern Banking Sys., Inc., 871 F.2d 734, 738 (8th Cir. 1989) (en banc). “The
failure to show irreparable harm is, by itself, a sufficient ground upon which to
deny a preliminary injunction . . . .” Id. “Irreparable harm occurs when a party has
no adequate remedy at law, typically because its injuries cannot be fully
compensated through an award of damages.” Gen. Motors Corp. v. Harry
Brown’s, LLC, 563 F.3d 312, 319 (8th Cir. 2009). Irreparable harm must be
certain and imminent such that there is a clear and present need for equitable relief.
Iowa Utils. Bd. v. F.C.C., 109 F.3d 418, 425 (8th Cir. 1996). Possible or
speculative harm is not sufficient. Local Union No. 884, United Rubber, Cork,
Linoleum, & Plastic Workers of Am. v. Bridgestone/Firestone, Inc., 61 F.3d 1347,
1355 (8th Cir. 1995). When there is an adequate remedy at law, a preliminary
injunction is not appropriate. Modern Computer Sys., 871 F.2d at 738.
Here, OmniPlus cannot show that it has no adequate remedy at law given
that the Provider Agreement and Manual permit Express Scripts to terminate the
agreement without cause upon 90 days written notice. Plaintiff’s counsel argued
for the first time at the preliminary injunction hearing that the Texas-specific
addendum prohibits any termination unless it is for cause. The basis for this
argument is § 5.1 of the Addendum, which requires Express Scripts to “provide a
written explanation to [OmniPlus] of the reason(s) for termination at least ninety
days prior to the effective date of such termination to the extent required by law.”
According to counsel, a “written explanation” means “for cause.” OmniPlus
offered no caselaw supporting this theory. OmniPlus has failed to carry its burden
of demonstrating any likelihood that it will succeed on the merits of its argument
that Express Scripts could not terminate the Provider Agreement with OmniPlus
without cause upon 90 days written notice.8 Even if OmniPlus might otherwise be
entitled to injunctive relief, its threat of irreparable harm is severely limited by the
fact that OmniPlus is not contractually entitled to network membership lasting
beyond 90 days.
For example, Express Scripts could provide, as its “written explanation” for the reason
for the termination, that it was exercising its right, under § 4.2.a of the Provider
Agreement, to terminate without cause.
Like the plaintiff in Trilogy Health Care, LLC v. Medco Health Solutions,
Inc., 2013 WL 4832708, *2 (D.N.J. Sept. 10, 2013), a case cited by Express Scripts
which is remarkably similar to the one at bar, OmniPlus is seeking injunctive relief
to which it has no entitlement under the Provider Agreement. Like the parties in
Trilogy Health, Express Scripts has also declared that its relationship with
OmniPlus is “over.” Therefore, under the best case scenario, OmniPlus would be
entitled to no more than 90 additional days of membership in Express Scripts’
network and a non-binding advisory review process which Express Scripts would
remain free to disregard. OmniPlus offers no evidence that continuation in Express
Scripts’ pharmacy network for some period not to exceed 90 days would be of
greater benefit to its business than an award of money damages for lost profits for
that same time period.
Instead, OmniPlus only offers vague, conclusory speculation that it will
incur “massive financial damage” which “may threaten” to put OmniPlus out of
business. OmniPlus offers no supporting evidence for Mr. Breimeister’s
speculative testimony that physicians may stop using their pharmacy entirely to
avoid the hassle of determining whether it remains in Express Scripts’ network.
Even if true, however, that evidence still fails to meet the threshold of irreparable
harm because OmniPlus has represented that only about two percent of its total
business is by mail order, and only five percent of the total business is from
compounding, which is the only type of OmniPlus’ business conceivably impacted
by this alleged harm. Mr. Breimeister provided no foundation for his testimony
that the business is “significant,” and OmniPlus’ retail customers, who apparently
comprise 98 % of its business, do not rely on their doctors to “call in” their
prescriptions and therefore can continue to bring their prescriptions to OnmiPlus if
they so choose.9 While the loss of Express Scripts’ business would undoubtedly
be substantial, there is no evidence suggesting that OmniPlus would suffer the kind
of financial ruin it alleges in its briefs.
Moreover, OmniPlus’ arguments fail to account for the fact that Express
Scripts has made clear that, even if OmniPlus gets the review process it seeks, it
will terminate the Provider Agreement as soon as the non-binding advisory panel
review is complete. Therefore, as the court in Trilogy Health found, an injunction
lasting 90 days “merely postpones the inevitable” and will not render the business
viable for a longer term. Id. at *4.
In addition, any alleged harm resulting from OmniPlus’ termination in
Express Scripts’ provider network was contemplated by the parties as it results
from the express terms of the Provider Agreement, which permits Express Scripts
to terminate OmniPlus’ membership even without cause upon 90 days written
Although plaintiff’s counsel tried to argue that the total percentage of OmniPlus’ mailorder and compounding business was much higher, he failed to actually introduce any
evidence on this point. The only evidence before me is OmniPlus’ verified Provider
Certification from March of 2014, and I see no reason not to accept it as true for purposes
of deciding this motion.
notice.10 As such, it cannot be considered “irreparable.” See Med-Care Diabetic
& Medical Supplies, Inc. v. Strategic Health Alliance, II, Inc.,2014 WL 325663, *5
(S.D. Ohio Jan. 29, 2014) (denying preliminary injunction to pharmacy seeking to
stop its termination from provider network because pharmacy was terminated
under provision permitting cancellation without cause upon 30-days notice;
pharmacy did not suffer irreparable harm because the contract contemplated
termination and therefore contemplated the alleged harm caused by termination).
Stated otherwise, the harm is purely economic and therefore not irreparable. While
OmniPlus believes it is entitled to significant damages, that fact alone does not
entitle OmniPlus to injunctive relief.
This is a standard breach of contract case in which the parties to the contract
specifically contemplated that Express Scripts could terminate it. I understand
OmniPlus’ position that the contract does not give Express Scripts the right to do it
in the way that they have done it, but nothing before me suggests that Express
Scripts does not have the power to terminate their network membership under the
Provider Agreement. Therefore, I cannot find that any damages flowing from that
contemplated conduct are somehow so unique as to constitute irreparable harm.
OmniPlus’ claims of potential lost customers and revenue are really just claims of
As stated above, OmniPlus offers no legal support for its newest argument that
terminations without cause are prohibited by Texas law. On the record before me I
simply cannot find that a “written explanation” for termination means that the termination
must be “for cause.”
lost profits, which can be calculated and fully compensated by an award of money
damages. They do not constitute irreparable harm sufficient to support the grant
of injunctive relief. See General Motors Corp., 563 F.3d at 319 (upholding denial
of injunction because claims of lost customers and revenues may be fully
compensated through an award of damages). The same is true of OmniPlus’
claims of intangible injuries to goodwill and reputation, which are supported by
nothing more than general business principles and are therefore too speculative to
establish irreparable harm. Id; see also Novus Franchising, Inc. v. Dawson, 725
F.3d 885, 895 (8th Cir. 2013) (loss of customers and customer goodwill are
compensable as money damages and do not support award of injunctive relief).
Although the lack of irreparable harm is a sufficient basis upon which to
deny injunctive relief, I have also considered the remaining Dataphase factors. I
do not find that the balance of equities favors injunctive relief because, if granted,
an injunction here would force these two parties to continue to do business together
even though their relationship is “over.” Like the Court in Trilogy Healthcare, I
too doubt “that this is a sensible remedy.” 2013 WL 4832708 at *1. This is
especially true here, where Express Scripts (whether rightly or wrongly) has
declared that it can no longer trust OmniPlus. Express Scripts has submitted
evidence that, if forced to continue doing business with OmniPlus, it will be
required to constantly monitor all of OmniPlus’ claims for accuracy, resulting in an
undue administrative burden and potential oversight by this Court. Granting an
injunction would also impact Express Scripts’ clients, for if the for-cause
termination of OmniPlus is ultimately justified, those clients will have been
required to continue to do business with a pharmacy which has potentially driven
up health care costs through improper billing practices. This could result in higher
premiums for members. These potential outcomes weigh against injunctive relief
when balanced against any potential harm to OmniPlus and any potential
disruption that may be experienced by members who can no longer get their
prescriptions filled by OmniPlus “in network.” OmniPlus offers no evidence that
any members of Express Scripts’ clients will be left without medication or access
to medication if it is terminated from the network. While it might be inconvenient
for some members or physicians to use a new pharmacy, this factor cannot justify
the grant of injunctive relief in this case. For these reasons, injunctive relief is not
Finally, the Court believes that this is a case ripe for early referral to
mediation. Counsel previously represented that the party representatives were
working well together; it appears to me that they might have achieved a potential
resolution to this problem until the outside lawyers got involved. This is a case
that should be settled, so the Court expects all counsel and the appropriate
representatives to use their best efforts (and hopefully, their common sense) to do
IT IS HEREBY ORDERED that plaintiff’s motion for preliminary
injunction [#16] is denied.
IT IS FURTHER ORDERED that defendants’ motion for leave to file a
supplemental brief [#57] is denied.
This case will be referred to mediation by separate Order and will be set for
a Rule 16 Scheduling Conference, if necessary, only after mediation is completed.
CATHERINE D. PERRY
UNITED STATES DISTRICT JUDGE
Dated this 7th day of October, 2014.
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?