On October 11, 2023, Pennsylvania Auditor General Timothy DeFoor announced an upcoming performance audit of all Medicaid managed care organization (MCO) contracts with pharmacy benefit managers (PBMs).
On June 21, the United States Congress took another step forward in its scrutiny of pharmacy benefit managers (PBMs) to "put an end to the hidden clawback fees that are squeezing.
On April 18, 2023, the Supreme Court of the United States heard arguments as to whether subjective intent is relevant in assessing scienter in a False Claims Act (FCA) case.
Ohio Attorney General Dave Yost filed a lawsuit in an Ohio court on March 28, 2023, that is the first of its kind. The suit accuses Express Scripts Inc. and Prime Therapeutics.
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Five months after the Supreme Court of the United States handed down a loss to the pharmacy
benefit manager (PBM) lobbying group Pharmaceutical Care Management
Association (PCMA), PCMA filed a brief in the Eighth Circuit
arguing that the Court s ruling does not narrow the scope of
Employee Retirement Income Security Act (ERISA) preemption for PBM
regulation.
On December 10, 2020, the Supreme Court, in
Rutledge v.
Pharmaceutical Care Management Association, ruled that an
Arkansas law prohibiting PBMs from reimbursing pharmacies for drugs
at rates below the drugs acquisition costs was not preempted