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191774P.pdf 09/04/2020 Trone Health Services, Inc. v. Express Scripts Holding Co.
U.S. Court of Appeals Case No: 19-1774
U.S. District Court for the Eastern District of Missouri - St. Louis
[PUBLISHED] [Smith, Author, with Loken and Gruender, Circuit Judges]
Civil case - Contracts. The plaintiff pharmacies alleged Express Scripts
breached its contracts with them by using confidential customer
information the pharmacies provided Express Scripts in order to switch the
customers to Express Scripts' mail-order service when it should have only
used the information to confirm customer coverage and reimburse the
pharmacies; the district court did not err in dismissing the claim
because: (1) HIPAA does not authorize the pharmacies to control or use
their customers' information or grant the pharmacies the power to enforce
their customers' rights and (2) the pharmacies failed to allege a breach
of contract based upon an alleged past or ongoing HIPAA violation because
they failed to allege that Express Scripts use of the HIPAA-protected
information lacked the express authorization of the insurance plan
sponsors; the district court did not err in finding the unambiguous
provisions of the parties' agreements permitted Express Scripts to
dispense pre-authorized refills to the plan sponsors' members and its
actions were not, therefore, a breach of the implied covenants of good
faith and fair dealing; claims the conduct constituted unfair competition,
misappropriation of trade secrets, tortious interference with business
expectancy and attempted monopolization rejected.