Supreme Court Deals Surprise Blow to PBMs in Rutledge Ruling

In a unanimous, earlier-than-expected decision that surprised some observers, the U.S. Supreme Court on Dec. 10 unanimously rejected a trade group’s challenge to a 2015 Arkansas law regulating PBMs. The rule paves the way for states to continue tightening the reins on the increasingly scrutinized “middlemen” in the prescription drug supply chain, provided that such measures involve rate regulation.

The managed care industry had been closely watching the case, Rutledge v. Pharmaceutical Care Management Association (PCMA). That’s because it has implications for not only Arkansas’ Act 900 — which requires PBMs to reimburse pharmacies at no less than what pharmacies pay to acquire drugs — but also a host of other PBM-targeting measures passed by states across the country.

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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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