Pills in bottle

Legal analysists are calling a recent court ruling a win for pharmacy benefit managers (PBMs) and self-funded health insurance plans, with an appeals court ruling that PBM structures such as requiring the use of mail-order pharmacies cannot be restricted by state law.

The case, Pharmaceutical Care Management Association (PCMA) v. Mulready, centered on Employee Retirement Income Security Act of 1974 (ERISA) and its preemption of state laws. ERISA allows the federal government to set uniform standards for retirement and health plans in the country, avoiding a patchwork quilt of health care regulations.

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