News & Analysis as of

Health Insurance Supreme Court of the United States Employee Retirement Income Security Act (ERISA)

Epstein Becker & Green

State Regulation of Pharmacy Benefit Managers: Tenth Circuit Holds That ERISA and Medicare Part D Preempt Key Parts of Oklahoma...

Epstein Becker & Green on

On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit (the “Tenth Circuit”) issued its decision in Pharmaceutical Care Management Association (PCMA) v. Mulready, one of the first major opinions to further define...more

Locke Lord LLP

Grappling With Increased Insurance ‎Regulatory Scrutiny of Pharmacy Benefit Managers

Locke Lord LLP on

Insurance regulators and examiners (“Insurance Regulators”) are increasing their efforts to scrutinize pharmacy benefit managers (“PBMs”), including conducting examinations of their business operations and initiating...more

ArentFox Schiff

Court Holds NC State Health Plan Constitutes “Health Program or Activity,” Granting Summary Judgment for Transgender Plaintiffs...

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On December 5, 2022, the US District Court for the Middle District of North Carolina held that the North Carolina State Health Plan (NCSHP) constitutes a “Health Program or Activity” under the Affordable Care Act (ACA). In so...more

Proskauer - Labor Relations Update

SCOTUS Denies Review and Leaves Seattle’s “Play-or Pay” Ordinance Intact

On November 21, 2022, the Supreme Court declined to review whether federal law preempts a Seattle Ordinance mandating that large hotels offer their employees health insurance coverage or increased pay. This left the Ninth...more

Holland & Hart - The Benefits Dial

I Wanna Know What Love Is . . . and When to Provide Domestic Partner Benefits

When the Supreme Court legalized same-sex marriages back in 2015, the IRS clarified that two people are legally married under federal law when they also are legally married under their state’s law. Because of this...more

Pillsbury - Policyholder Pulse blog

Abortion as an Employee Health Benefit – How to Protect against Potential Liability Post-Dobbs

Amazon. Bank of America. Citigroup. Dick’s Sporting Goods. JP Morgan. Kroger. Meta. Microsoft. Procter & Gamble. Target. Walt Disney Company. These are just a few of what is a growing list of companies that have offered to...more

Proskauer - Employee Benefits & Executive...

After Dobbs v. Jackson Women’s Health Organization: Impact on Employee Benefits

Employers and other group health plan sponsors are left with much to consider following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overruled the Supreme Court’s prior landmark...more

Proskauer - Employee Benefits & Executive...

Post-Dobbs: FAQs for Employers and Other Benefit Plan Sponsors

Can group health plans continue to provide coverage for abortion-related expenses? In short, yes. Dobbs does not prohibit group health plans from covering abortion-related expenses. Instead, Dobbs eliminates federal...more

Burr & Forman

What Employers Need To Know in a Post-Roe World

Burr & Forman on

On June 24, 2022, the Supreme Court issued its decision in Dobbs v. Jackson Women’s Health Organization, overturning Roe v. Wade, the 1973 ruling that protected a woman’s right to have an abortion. In Dobbs, the Supreme Court...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Medical Travel Reimbursement Benefits Under the Supreme Court’s New Dobbs Decision

On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more

ArentFox Schiff

As It Mulls Whether To Grant Cert in ERISA Case on PBM Fiduciary Liability, Supreme Court Seeks Government's Input

ArentFox Schiff on

In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If...more

McGuireWoods Consulting

The Courts and Healthcare Policy - July 2021

2020 saw the courts continuing to play an important role in health policy with several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

Foley & Lardner LLP

50 State Map of MAC Laws – Can PBMs No Longer Rely on ERISA Preemption to Avoid Certain State Laws?

Foley & Lardner LLP on

Recent court trends suggest that preemption under the Employee Retirement Income Security Act (ERISA) may not apply to certain state laws that regulate pharmacy benefit managers (PBMs), including state laws governing Maximum...more

Harris Beach PLLC

U.S. Supreme Court Decision Supports State Regulation of Pharmacy Benefit Managers

Harris Beach PLLC on

The U.S. Supreme Court’s recent unanimous decision clears the way for state regulation of Pharmacy Benefit Managers (“PBMs”). Rutledge v. Pharm. Care Mgmt. Ass’n, 141 S. Ct. 474 (2020). At issue before the High Court was...more

Akerman LLP - Health Law Rx

New Supreme Court Ruling Affirms State Regulation of PBM Reimbursement Pricing

The U.S. Supreme Court ruled against pharmacy benefit managers (“PBMs”) last month, in a decision that marks a major win for state regulators. (See Rutledge v. Pharmaceutical Care Management Association, 2020 WL 7250098 (U.S....more

Locke Lord LLP

Supreme Court Rules ERISA Does Not Preempt Arkansas’ PBM Regulation

Locke Lord LLP on

Recently, the Supreme Court released its decision in Rutledge v. Pharmaceutical Care Management Association. The case considers whether the Employee Retirement Income Security Act of 1974 (“ERISA”) preempts an Arkansas state...more

Mintz - Employment Viewpoints

Supreme Court Holds that ERISA Does Not Preempt Arkansas PBM Law: The Impact on Employer Sponsored Group Health Plans

In a recently decided case, Rutledge v. Pharmaceutical Care Management Association, the U.S. Supreme Court held that the Employee Retirement Income Security Act of 1974 (ERISA) does not preempt an Arkansas statute that...more

Groom Law Group, Chartered

The Supreme Court Narrows ERISA Preemption in Rutledge v. PCMA

In the recently-decided Rutledge v. Pharmaceutical Care Management Association (“PCMA”), the Supreme Court found 8–0 (Justice Barrett did not take part) that ERISA did not preempt an Arkansas state law that established...more

White & Case LLP

Supreme Court Green Lights Arkansas Law Regulating PBM Pricing Practices

White & Case LLP on

On December 10, 2020, the Supreme Court in Rutledge v. Pharmaceutical Care Management Association held that ERISA does not pre-empt an Arkansas law regulating PBM prescription drug payment rates to pharmacies because it...more

K&L Gates LLP

340B Update: Recent Supreme Court Ruling May Curtail 340B Program Discriminatory Pricing

K&L Gates LLP on

The U.S. Supreme Court recently issued a unanimous decision in Rutledge v. Pharmaceutical Care Management Ass’n, which supports the validity of state statutes that regulate reimbursement rates pharmacy benefit managers (PBMs)...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decision Caps Big Week in Litigation for Pharmacy Benefit Managers

The U.S. Supreme Court handed down a decision on Thursday of last week that will impact state-level regulation of pharmacy benefit managers (PBMs) by holding that an Arkansas law regulating PBMs was not preempted by the...more

Ballard Spahr LLP

Supreme Court Finds ERISA Does Not Preempt State Prescription Drug Pricing Law

Ballard Spahr LLP on

Summary The U.S. Supreme Court unanimously upheld an Arkansas statute that regulates the price that pharmacy benefit managers (PBMs) pay retail pharmacies for prescription drugs.   ...more

Robinson+Cole ERISA Claim Defense Blog

Supreme Court Rules that ERISA Does Not Preempt State Law Regulating PBM Reimbursements

In Rutledge v. Pharmaceutical Care Mgt. Assoc., — U.S. –, 2020 WL 7250098 (Dec. 10, 2020), the Supreme Court held that ERISA’s broad express preemption will not reach a state law that focuses on the price of prescription drug...more

BakerHostetler

Supreme Court Gives Nod to States Regulating Pharmacy Benefit Managers Reimbursement

BakerHostetler on

On Dec. 10, the United States Supreme Court issued its ruling in Rutledge v. Pharmaceutical Care Management Association. The Court reversed the 8th Circuit to uphold a state’s ability to regulate the price at which pharmacy...more

Jackson Lewis P.C.

U.S. Supreme Court: State Law Regulating Pharmacy Benefit Managers Is Not Preempted By ERISA

Jackson Lewis P.C. on

An Arkansas law regulating pharmacy benefit managers’ (PBMs) generic drug reimbursement rates, and affecting the cost of prescription drugs provided under ERISA-governed benefit plans and the administration of those plans, is...more

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