8th Circuit win paves the way for states to regulate PBMs

NCPA November 17, 2021

NCPA and other pharmacy organizations are cheering a decision by the 8th Circuit of the U.S. Court of Appeals on Wednesday supporting North Dakota’s right to regulate PBMs. The case, Pharmaceutical Care Management Association v. Wehbi, is the first to consider at the federal appellate level the scope of the U.S. Supreme Court’s unanimous decision last year in Rutledge v. PCMA, which upheld an Arkansas state law regulating the abusive practices of PBMs. (PCMA is a trade association for pharmacy benefit managers; Nizar Wehbi is the North Dakota State Health Officer.) In July, NCPA, along with the American Pharmacists Association and the North Dakota Pharmacists Association, and pharmacy associations of six additional states within the jurisdiction of the 8th Circuit, filed a friend of the court brief defending North Dakota’s position in the case. Oral arguments were held on Sept. 1. “With this decision the 8th Circuit is starting to right its previous wrongs, affirming how states can use Rutledge to appropriately regulate health care’s mega-middlemen and protect citizens from harmful PBM business practices,” said NCPA CEO Douglas Hoey. “We applaud North Dakota for pursuing PBM reforms through legislation and, when necessary, litigation. These fights may continue, but policymakers considering similar PBM restrictions can take comfort in the fact that courts are recognizing states’ obligation to protect patients and local businesses and upholding their efforts to do just that.” The 8th Circuit decision has implications far beyond North Dakota. With most states actively seeking to regulate PBMs, the ruling clears the way for all states to regulate many PBM practices that PCMA argued were exempted by ERISA. Additionally, the court found that certain PBM practices within Medicare can also be regulated by the states. NCPA’s participation in landmark cases such as this is possible through the NCPA Legislative/Legal Defense Fund. Here’s how you can invest in the fund.

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