Texas Should Extend PBM Laws to ERISA Plans, NCPA Testifies

States can protect citizens by further regulating PBMs, says NCPA general counsel

NCPA May 18, 2022

ALEXANDRIA, Va. (May 18, 2022) – In testimony today to the Texas House of Representatives’ Insurance Committee, National Community Pharmacists Association General Counsel Matthew Seiler said that given recent court rulings including the Rutledge v. PCMA Supreme Court case, Texas can take comfort in extending its existing commonsense laws regulating pharmacy benefit managers so they also apply to PBMs serving self-funded ERISA plans. In Rutledge, the Supreme Court determined that the federal ERISA statute does not preclude Arkansas from protecting patients and local businesses by regulating PBMs serving these plans. This decision has since been reflected in PCMA v. Wehbi, which supports North Dakota’s right to regulate PBMs.

“In the wake of Rutledge, there is growing consensus that states should exercise their authority to regulate PBMs — regardless of the type of plan that the PBM is serving,” Seiler wrote in his comments as prepared for delivery. “Even before the Supreme Court decided Rutledge, the federal government, forty-six states, including the state of Texas and the District of Columbia, filed briefs with the Supreme Court arguing that states have robust authority to regulate PBMs.

“As a result, there has been a recent surge of state-level regulation of PBMs, and the push for such regulation has straddled the political divide. Red states and blue states — from Arkansas to California, and everywhere in between — have enacted or are considering legislation to further regulate PBMs. Texas should do the same by extending its existing laws to regulate PBMs when they are serving ERISA plans.”

Click for Seiler’s prepared testimony.

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Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ approximately 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.

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