USA TODAY
WASHINGTON ― The Supreme Court ruled unanimously Thursday that states can regulate pharmacy benefit managers, the prescription drug middlemen whose actions affect 250 million Americans.
The ruling is a victory for 45 states, led by Arkansas, and independent pharmacies that sought to stop so-called PBMs, which process prescription drug claims and then reimburse pharmacies, from keeping reimbursement rates low for generic drugs. That has caused thousands of independent pharmacies to close, particularly in rural areas.
The case, which was argued in October, garnered little attention compared to the major health care dispute over the Affordable Care Act that the high court heard in November. That case ― in which a coalition of states led by Texas seeks to have the law declared unconstitutional because Congress eliminated the tax penalty intended to enforce insurance coverage ― isn t likely to be decided until the spring.
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Supreme Court Rules that Arkansas Act 900, Affecting the Prices that PBMs Pay to Pharmacies, Is Not Preempted Under ERISA Friday, December 11, 2020
On December 10, 2020, the Supreme Court released its decision in
Rutledge v. Pharmaceutical Care Management Association. Justice Sotomayor wrote the Court’s opinion, which was joined by all Members of the Court except Justice Barrett, who did not participate. Justice Thomas filed a concurring opinion, which expressed his prior opinions that the Court’s ERISA preemption tests have strayed from the text of ERISA’s statutory language.
The question presented was whether ERISA preempts Arkansas Act 900, an Arkansas law that regulates the price at which pharmacy benefit managers (PBMs) reimburse pharmacies for the cost of drugs covered by prescription drug plans. PCMA, the Pharmaceutical Care Management Association, which represents some of the largest PBMs in the country, challenged Arkansas Act 900 by argu
Search jobs Specialty Pharmacy Applauds Supreme Court Decision to Allow States to Regulate PBM Practices
WASHINGTON, Dec. 11, 2020 /PRNewswire/ The National Association of Specialty Pharmacy (NASP) applauds the 8-0 decision by the Supreme Court to restore Arkansas right to govern the amount that Pharmacy Benefit Managers (PBMs) reimburse pharmacies, in Rutledge v. the Pharmaceutical Care Management Association (PCMA). This decision will give states more flexibility to oversee PBM reimbursement practices to ensure patient access and affordability and protect market competition.
Since 2012, NASP members have reported a dramatic decrease in prescription reimbursement and an increase in claw-back fees such as Direct and Indirect Remuneration (DIR) by many PBMs.
Send In a ruling seen as a win for local pharmacies, The U.S. Supreme Court on Thursday reversed a lower court decision that prevented a 2015 state law regulating pharmacy benefit managers from going into effect.
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