The U.S. Supreme Court recently issued a unanimous decision
1 in
Rutledge v. Pharmaceutical Care Management Ass’n,
2 which supports the validity of state statutes that regulate reimbursement rates pharmacy benefit managers (PBMs) pay to pharmacies. Specifically, the Supreme Court’s ruling upheld Arkansas’s Act 900 (the Act)
3 requiring PBMs to reimburse pharmacies at a rate equal to or greater than the pharmacies’ acquisition costs, concluding that the Act was not preempted by the Employee Retirement Income Security Act of 1974 (ERISA),
4 even though it regulates the price at which PBMs must reimburse pharmacies for drugs covered by prescription drug plans.
Tuesday, December 22, 2020
1 in
Rutledge v. Pharmaceutical Care Management Ass’n,
2 which supports the validity of state statutes that regulate reimbursement rates pharmacy benefit managers (PBMs) pay to pharmacies. Specifically, the Supreme Court’s ruling upheld Arkansas’s Act 900 (the Act)
3 requiring PBMs to reimburse pharmacies at a rate equal to or greater than the pharmacies’ acquisition costs, concluding that the Act was not preempted by the Employee Retirement Income Security Act of 1974 (ERISA),
4 even though it regulates the price at which PBMs must reimburse pharmacies for drugs covered by prescription drug plans.
Rutledge is a significant win for pharmacies and health care providers with pharmacy operations, and particularly health care providers participating in the 340B Drug Discount Program (the 340B Program). In recent years, numerous states have enacted laws prohibiting PBMs from imposing a discriminatory two-tier pricing model for dr