ALEXANDRIA, Va. — The National Community Pharmacists Association (NCPA), the Arkansas Pharmacists Association (APA), and the American Pharmacists Association (APhA) responded to the Pharmaceutical Care Management Association’s (PCMA) amicus brief which opposes states’ rights to regulate pharmacy benefit managers (PBM) in Rutledge v. PCMA.
In their amicus brief, PCMA opposes the contention that preemption applies only when a plan manages benefits directly and not when it engages a third party to do so on the plan’s behalf, stating that “accepting it would penalize employers and their beneficiaries for obtaining help in the massive task of administering employee health benefits.”
“The PBMs have been hiding behind the false argument that ERISA preempts the states from adopting reasonable regulation, said B. Douglas Hoey, NCPA CEO. “ERISA was never intended to be a force field around corporate middlemen hired by the plans. We are confident that the Supreme Court will agree.”
The PBMs have argued for decades that they are exempt from state regulation by vague language in the Employer Retirement Income Security Act of 1974. The law precludes states from regulating employee benefit plans, but not third-party vendors hired by the plans.
“PBMs continue to insist on a regulatory vacuum that gives them complete freedom to exploit the healthcare system with no oversight at all,” Arkansas Pharmacists Association CEO John Vinsonsaid. “The country’s current public health emergency shows how important frontline healthcare workers like pharmacists are to the health and safety of the American people, yet PBMs set their priorities on profits. PBM regulations provide an even playing field and consistent transparency that benefits all parties involved, especially patients.”
“Patients are rapidly losing access to a readily available, knowledgeable health care provider as unregulated PBM practices starve pharmacies of fair and adequate reimbursement using unfair trade practices and leverage illegal in other areas of health care,” said APhA executive vice president and CEO Thomas Menighan. “Regulating PBMs is vital to preserving the benefits that pharmacists are valued for— helping patients make the most of their medications, avoiding preventable illnesses, managing chronic diseases, and keeping them out of the hospital. Patients need access to their pharmacists. Without fair regulation the future of accessibility to pharmacists is in jeopardy.”
The arguments in Rutledge v. PCMA are set to heard by the Supreme Court on April 27, 2020.