Four national pharmacy organizations blasted an Aug. 15 decision by the 10th Circuit Court of Appeals allowing pharmacy benefit managers (PBMs) to escape certain state regulations in Oklahoma by hiding behind the alleged preemption of that law by federal ERISA and Medicare Part D laws.
The National Community Pharmacists Association, the American Pharmacists Association, the National Association of Chain Drug Stores, American Pharmacies and the Oklahoma Pharmacists Association jointly signed on as amici to defend Oklahoma’s 2019 law regulating PBMs. The PBM lobby, the Pharmaceutical Care Management Association, challenged the law in federal court. In 2022, the U.S. District Court for the Western District of Oklahoma largely upheld the law.
PCMA appealed only four of the 13 originally challenged provisions. The District Court’s decision on the four remaining provisions was overturned on Aug. 15 by the Tenth Circuit.
“The 10th Circuit decision is inconsistent with what other federal courts have decided, and it departs from the Supreme Court’s unanimous Rutledge decision, which clearly held that PBMs can’t hide behind ERISA. It must be overturned,” –B. Douglas Hoey, CEO, NCPA
“The Supreme Court in Rutledge opened the door for states to regulate PBM transparency and accountability in otherwise opaque and heavy-handed dealings. The Mulready decision creates greater confusion rather than much-needed clarity for Oklahoma and other states,” –Michael D. Hogue, CEO and executive vice president, APhA
“The legal problems with the Tenth Circuit’s ruling are significant – including that it relies on a theory of preemption that the U.S. Supreme Court repeatedly has called ‘unsettling.’ The need is very, very real for state and federal action to confront PBM tactics that harm patients, the pharmacies that serve them, and virtually all Americans,” –Steven C. Anderson, president and CEO, NACDS