PBM Lobby’s Legal Victory Is Perhaps an Even Bigger Deal to Large Employers

August 24

A federal appeals court on Aug. 16 delivered a significant victory for the under-fire PBM industry, ruling that an Oklahoma law regulating PBMs is preempted by federal statutes. Officials at lobbying groups that are closely watching the case say that the dispute may wind up before the Supreme Court — and if that occurs, employer plan sponsors will arguably have more at stake than PBMs themselves.

“I think it is highly likely to be appealed and to be pursued further,” says Dillon Clair, director of state advocacy and litigation at the ERISA Industry Committee (ERIC), which represents the employee-benefits interests of large employers. “This is a big case, not just for Oklahoma and their law and the employers that are going to have to comply with that, but for all the other state laws that have [been] enacted” and for states looking to follow suit.

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Radar on Drug Benefits

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.