PCMA vs. Rutledge

Foley Hoag LLP successfully represented client Pharmaceutical Care Management Association (PCMA) in a lawsuit in which the firm sought to invalidate Arkansas law Act 900, which restricted pharmacy benefit management (PBM) tools and required employers and consumers to pay higher rates to independent drugstores for prescription drugs. The victory was awarded in a unanimous three judge decision in the Eighth United States Circuit Court of Appeals.

The decision strikes down Act 900 for Medicare Part D drug plans, reversing a lower court’s ruling. The appeals court also upheld the lower court’s earlier decision, in favor of PCMA, which held that the law was preempted by the Employee Retirement Income Security Act (ERISA).

Enacted in 2015, Act 900 mandated that PBMs reimburse pharmacies for generic drugs at a price equal to or higher than the price listed on the pharmacies invoice from the wholesaler and authorized pharmacies to refuse to dispense needed medications to seniors and other Arkansans if reimbursement was below that price.

PCMA is the national association representing America’s pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.

The Foley Hoag team representing PCMA was led by partner Dean Richlin (Picture), and was comprised of Barker, partner Kristyn Bunce DeFilipp, and associates Andrew London and Ross Margulies.

Involved fees earner: Dean Richlin – Foley Hoag; Kristyn Bunce DeFilipp – Foley Hoag; Andrew London – Foley Hoag; Ross Margulies – Foley Hoag;

Law Firms: Foley Hoag;

Clients: Pharmaceutical Care Management Association (PCMA);

Author: Ambrogio Visconti