SCOTUS Hearing Hints at PBM Win in Case Against State Regs

Following an Oct. 6 Supreme Court hearing, legal experts tell AIS Health that PBMs appear to have a good shot at prevailing in their challenge of a 2015 Arkansas law, which has major implications for how both health and drug benefits are regulated.

The case, Rutledge v. Pharmaceutical Care Management Association (PCMA), centers on a law known as Act 900 that aimed to protect independent pharmacies from what Arkansas Attorney General Leslie Rutledge calls the “abusive payment practices” of PBMs. Chiefly at issue is whether Arkansas can force PBMs to reimburse pharmacies for the price of any given drug set by the pharmacy’s wholesaler, even if that amount is higher than the maximum allowable cost (MAC) set by a PBM.

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Leslie Small

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.

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