Solicitor General to weigh in on pharmacy benefit managers case

ADA previously filed amicus brief about federal ERISA law

The U.S. Supreme Court asked the U.S. solicitor general for input on a case that could change states’ ability to regulate pharmacy benefit managers, leading to a precedent for dental benefits. 

In Mulready v. the Pharmaceutical Care Management Association, the case in question, an Oklahoma pharmacy benefit managers law is currently being challenged. This month, the Supreme Court invited the solicitor general to “file a brief in this case expressing the views of the United States.” The ADA filed an amicus brief supporting a state request that the Supreme Court review the appellate court’s decision.

As the federal government’s chief lawyer before the Supreme Court, the solicitor general almost always files a brief when invited to do so. This request indicates the high court is interested in the case, which potentially could alter the way states regulate pharmacy benefit managers. The solicitor general was likely asked to weigh in since the case involves a federal statute: The Employee Retirement Income Security Act of 1974, a bill originally created to set standards for many private retirement and health plans, including self-funded dental plans.  

In 2019, the Pharmaceutical Care Management Association, a trade association representing pharmacy benefit managers, sued Oklahoma Insurance Commissioner Glen Mulready in an effort to invalidate the state’s Patient’s Right to Pharmacy Choice Act. Pharmacy benefit managers manage prescription drug benefits for health insurance plans by negotiating prices with drug manufacturers and contracting with pharmacies. The organization alleged that ERISA preempted the act, but the district court ruled that ERISA did not. Later, the Tenth Circuit Court of Appeals reversed, holding that ERISA preempts four challenged provisions.   
  
In June, the ADA filed an amicus brief urging the Supreme Court to review the Mulready v. PCMA case, which limits states’ authority to regulate health care and insurance. Some carriers claim that ERISA preempts state rules because it is a federal law, allowing carriers to ignore state insurance laws meant to protect patients. However, the ADA said most state laws can be applied to all carriers, including those administering self-funded dental plans for employers.  
  
There is no deadline by which the brief must be filed, but once it is, the government’s recommendation about Mulready v. PCMA will likely carry significant weight.