News & Analysis as of

Employee Retirement Income Security Act (ERISA) Pharmacies

Holland & Hart - The Benefits Dial

Hole in the Bottle… Employer Considerations After Another Lawsuit Against an Employer Health Plan

Last week, former Wells Fargo employees filed a class action lawsuit against Wells Fargo and its health plan fiduciaries alleging that Wells Fargo’s self-funded health plan violated ERISA by paying its pharmacy benefits...more

Hall Benefits Law

32 State AGs Urge Justices to Review 10th Circuit Ruling Concerning ERISA Preemption of State PBM Law

Hall Benefits Law on

​​​​​​​A bipartisan group of attorneys general from 31 states and the District of Columbia filed an amicus brief in support of a petition for certiorari by Oklahoma’s insurance commissioner to review a decision by the U.S....more

Snell & Wilmer

Perplexed and the Fiduciary Committee – PBM Edition

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I read the Lewandowski v. Johnson & Johnson class action complaint and couldn’t help but wonder – are plans and participants doomed, or can employers take proactive steps to satisfy their fiduciary duties and potentially...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Florida PBM Law Limits Mail-Order Prescription Drug Programs, Requires State Filings by Employer Plans

Employers that cover Florida employees under their prescription drug plans are now prohibited from imposing mandatory mail-order requirements and are required to provide a sixty-day continuity of care period following midyear...more

Epstein Becker & Green

State Regulation of Pharmacy Benefit Managers: Tenth Circuit Holds That ERISA and Medicare Part D Preempt Key Parts of Oklahoma...

Epstein Becker & Green on

On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit (the “Tenth Circuit”) issued its decision in Pharmaceutical Care Management Association (PCMA) v. Mulready, one of the first major opinions to further define...more

Bass, Berry & Sims PLC

Tenth Circuit Rules ERISA Preempts Oklahoma PBM-Reform Law

Bass, Berry & Sims PLC on

In a win for self-funded (i.e., self-insured) health plans subject to the Employee Retirement Income Security Act of 1974, as amended (ERISA), the Tenth Circuit recently ruled that ERISA preempts provisions of an Oklahoma law...more

Foley Hoag LLP

10th Circuit Invalidates Oklahoma Pharmacy Network Law as Applied to ERISA and Medicare Part D Plans

Foley Hoag LLP on

The U.S. Court of Appeals for the 10th Circuit issued a sweeping decision that (1) maintains long-standing federal protections for employer and union-sponsored health plans to design their health benefit plans, including...more

Dorsey & Whitney LLP

Tenth Circuit Holds Oklahoma’s Regulation of Pharmacy Benefit Managers Preempted by ERISA

Dorsey & Whitney LLP on

ERISA’s notorious preemption clause is no more than a few lines of text. But it has a dramatic effect on the trillions of dollars flowing through ERISA pension and health plans in any given year. The U.S. Supreme Court has...more

McDermott Will & Emery

Tenth Circuit Reaffirms Preemption of State Pharmacy Network Regulations

McDermott Will & Emery on

The US Court of Appeals for the Tenth Circuit recently held in Pharmaceutical Care Management Association (PCMA) v. Mulready that the Employee Retirement Income Security Act (ERISA) and Medicare Part D preempted several...more

Locke Lord LLP

Grappling With Increased Insurance ‎Regulatory Scrutiny of Pharmacy Benefit Managers

Locke Lord LLP on

Insurance regulators and examiners (“Insurance Regulators”) are increasing their efforts to scrutinize pharmacy benefit managers (“PBMs”), including conducting examinations of their business operations and initiating...more

Holland & Knight LLP

Florida Enacts Comprehensive Pharmacy Benefit Plan Regulation

Holland & Knight LLP on

This legislative session, Florida has joined Arkansas and Oklahoma among the most regulatory-minded states with respect to pharmacy benefit plans and programs as well as pharmacy benefit managers (PBMs). Florida's...more

McDermott Will & Emery

ERISA Preemption Developments in Managed Care

McDermott Will & Emery on

For plans governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001-1461 (ERISA), the doctrine of federal ERISA preemption over state statutes, regulations or administrative schemes has been a central...more

Foley & Lardner LLP

50 State Map of MAC Laws – Can PBMs No Longer Rely on ERISA Preemption to Avoid Certain State Laws?

Foley & Lardner LLP on

Recent court trends suggest that preemption under the Employee Retirement Income Security Act (ERISA) may not apply to certain state laws that regulate pharmacy benefit managers (PBMs), including state laws governing Maximum...more

Harris Beach PLLC

U.S. Supreme Court Decision Supports State Regulation of Pharmacy Benefit Managers

Harris Beach PLLC on

The U.S. Supreme Court’s recent unanimous decision clears the way for state regulation of Pharmacy Benefit Managers (“PBMs”). Rutledge v. Pharm. Care Mgmt. Ass’n, 141 S. Ct. 474 (2020). At issue before the High Court was...more

Akerman LLP - Health Law Rx

New Supreme Court Ruling Affirms State Regulation of PBM Reimbursement Pricing

The U.S. Supreme Court ruled against pharmacy benefit managers (“PBMs”) last month, in a decision that marks a major win for state regulators. (See Rutledge v. Pharmaceutical Care Management Association, 2020 WL 7250098 (U.S....more

Locke Lord LLP

Supreme Court Rules ERISA Does Not Preempt Arkansas’ PBM Regulation

Locke Lord LLP on

Recently, the Supreme Court released its decision in Rutledge v. Pharmaceutical Care Management Association. The case considers whether the Employee Retirement Income Security Act of 1974 (“ERISA”) preempts an Arkansas state...more

Mintz - Employment Viewpoints

Supreme Court Holds that ERISA Does Not Preempt Arkansas PBM Law: The Impact on Employer Sponsored Group Health Plans

In a recently decided case, Rutledge v. Pharmaceutical Care Management Association, the U.S. Supreme Court held that the Employee Retirement Income Security Act of 1974 (ERISA) does not preempt an Arkansas statute that...more

Groom Law Group, Chartered

The Supreme Court Narrows ERISA Preemption in Rutledge v. PCMA

In the recently-decided Rutledge v. Pharmaceutical Care Management Association (“PCMA”), the Supreme Court found 8–0 (Justice Barrett did not take part) that ERISA did not preempt an Arkansas state law that established...more

White & Case LLP

Supreme Court Green Lights Arkansas Law Regulating PBM Pricing Practices

White & Case LLP on

On December 10, 2020, the Supreme Court in Rutledge v. Pharmaceutical Care Management Association held that ERISA does not pre-empt an Arkansas law regulating PBM prescription drug payment rates to pharmacies because it...more

K&L Gates LLP

340B Update: Recent Supreme Court Ruling May Curtail 340B Program Discriminatory Pricing

K&L Gates LLP on

The U.S. Supreme Court recently issued a unanimous decision in Rutledge v. Pharmaceutical Care Management Ass’n, which supports the validity of state statutes that regulate reimbursement rates pharmacy benefit managers (PBMs)...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decision Caps Big Week in Litigation for Pharmacy Benefit Managers

The U.S. Supreme Court handed down a decision on Thursday of last week that will impact state-level regulation of pharmacy benefit managers (PBMs) by holding that an Arkansas law regulating PBMs was not preempted by the...more

Ballard Spahr LLP

Supreme Court Finds ERISA Does Not Preempt State Prescription Drug Pricing Law

Ballard Spahr LLP on

Summary The U.S. Supreme Court unanimously upheld an Arkansas statute that regulates the price that pharmacy benefit managers (PBMs) pay retail pharmacies for prescription drugs.   ...more

Robinson+Cole ERISA Claim Defense Blog

Supreme Court Rules that ERISA Does Not Preempt State Law Regulating PBM Reimbursements

In Rutledge v. Pharmaceutical Care Mgt. Assoc., — U.S. –, 2020 WL 7250098 (Dec. 10, 2020), the Supreme Court held that ERISA’s broad express preemption will not reach a state law that focuses on the price of prescription drug...more

BakerHostetler

Supreme Court Gives Nod to States Regulating Pharmacy Benefit Managers Reimbursement

BakerHostetler on

On Dec. 10, the United States Supreme Court issued its ruling in Rutledge v. Pharmaceutical Care Management Association. The Court reversed the 8th Circuit to uphold a state’s ability to regulate the price at which pharmacy...more

Jackson Lewis P.C.

U.S. Supreme Court: State Law Regulating Pharmacy Benefit Managers Is Not Preempted By ERISA

Jackson Lewis P.C. on

An Arkansas law regulating pharmacy benefit managers’ (PBMs) generic drug reimbursement rates, and affecting the cost of prescription drugs provided under ERISA-governed benefit plans and the administration of those plans, is...more

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