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August 18, 2023

Tenth Circuit Rules in Favor of ERISA and Medicare Part D Preemption

On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit issued its unanimous opinion in PCMA v. Mulready.   The opinion opens as follows:

The Constitution ordains a federal system under which the federal and state governments share power. But when federal and state laws collide, the Constitution is clear: Federal law wins. This case is about a collision between federal law and Oklahoma law.

The case arose from the Oklahoma legislature’s passage in 2019 of the Patient’s Right to Pharmacy Choice Act and subsequent rules promulgated by the Oklahoma Insurance Department to regulate pharmacy benefit managers (PBMs).  The Pharmaceutical Care Management Association (PCMA) represents PBMs from around the country and sued to invalidate the Act, arguing that the federal ERISA law and Medicare Part D preempted several provisions in the Oklahoma law.  The district court disagreed with the ERISA preemption arguments, but held that Medicare Part D preempted six of the thirteen provisions being challenged by PCMA.  PCMA appealed the district court’s ruling on four provisions.  The Tenth Circuit reversed, holding that ERISA and Medicare Part D preemption applied to the four provisions.

Here is a link to PCMA’s press release on this important opinion, which may receive U.S. Supreme Court review. 

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