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Osterhaus Pharmacy v. CVS Health, Caremark, and Aetna

The National Community Pharmacists Association loudly applauded a class action lawsuit filed against vertically conslidated CVS Health, Caremark, and Aetna that aims to recoup for independent pharmacies millions of dollars in what the lawyers say are wrongful back-end penalties for Medicare Part D prescriptions, otherwise known as pharmacy direct and indirect remuneration fees.

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Pharmaceutical Care Management Association v. Wehbi

North Dakota PBM Litigation

Pharmaceutical Care Management Association v. Wehbi

NCPA is one of nine pharmacy associations that filed a friend of the court (amicus curiae) brief in the Eighth Circuit of the U.S. Court of Appeals defending North Dakota's right to regulate PBMs. Before North Dakota's law went into effect, the Pharmaceutical Care Management Association sued to prevent the state from enforcing it. Originally known as PCMA v. Tufte, then PCMA v. Wilke and now PCMA v. Wehbi, PCMA's lawsuit claimed that two federal laws, the Employee Retirement Income Security Act of 1974 (ERISA) and Medicare Part D, prevent North Dakota from regulating PBMs. The U.S. Court of Appeals for the Eighth Circuit agreed, invalidating North Dakota's PBM law in its entirety. After the Supreme Court win in Rutledge v. PCMA, the Eighth Circuit's decision in the North Dakota case was vacated and sent back to the Eighth Circuit for further consideration.

This case is the first at the federal appellate level to consider the scope of the U.S. Supreme Court's unanimous decision in Rutledge v. PCMA upholding an Arkansas state law regulating the abusive practices of PBMs.

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SCOTUS

Arkansas PBM Litigation

Rutledge v. Pharmaceutical Care Management Association (PCMA)

The Supreme Court of the United States issued its landmark ruling in Rutledge v. Pharmaceutical Care Management Association (PCMA), determining whether community pharmacies are protected from abusive payment practices.

The unanimous (8 to 0) decision ruled in favor of the interests of patients and community pharmacies, who have been fighting for years to regulate pharmacy benefit managers (PBMs), the controversial middlemen that manage prescription drug benefits for health insurers, Medicare Part D drug plans, and large employers. With this ruling, states will have greater authority to protect their local businesses and their patients from PBM overreach.

"This is a historic victory for independent pharmacies and their patients. And it confirms the rights of states to enact reasonable regulations in the name of fair competition and public health," said National Community Pharmacists Association CEO B. Douglas Hoey, pharmacist, MBA.

At issue was the extent to which the federal Employee Retirement Income Security Act of 1974 (ERISA), which regulates private employee benefit plans, preempts the states from regulating the amount that PBMs pay pharmacies to dispense prescription drugs that are covered by an employer-sponsored health plan.

There are other important cases working their way through the courts, and there will be lots more legislative activity in Congress and the states on which NCPA will be leading the fight. We need your help, so please consider making a donation to the NCPA Legislative/Legal Defense Fund.

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