On June 30, 2025, the U.S. Supreme Court decided not to review the case of Pharmaceutical Care Management Association (PCMA) v. Mulready. This decision leaves in place a ruling by the U.S. Court of Appeals for the 10th Circuit concerning state regulation of pharmacy benefit managers (PBMs). The decision upholds ERISA preemption and limits states' influence on employer-sponsored health plans.
The 10th Circuit found that several provisions in an Oklahoma statute aimed at regulating PBMs were preempted by ERISA. ERISA is a federal law governing employer-provided health and pension benefits, which includes a preemption provision that prevents states from enacting laws related to employer-sponsored health plans.
In 2020, the Supreme Court's decision in Rutledge v. PCMA narrowed ERISA preemption, allowing states to regulate PBMs contracting with self-funded ERISA plans. The Rutledge case involved an Arkansas statute setting reimbursement floors for pharmacies, which was upheld by the court.
While Rutledge allowed some state regulation of PBMs, the Supreme Court's choice not to review Mulready suggests a developing legal framework regarding state regulation boundaries under federal law. The Mulready decision affects jurisdictions within the 10th Circuit but serves as guidance for other courts and lawmakers.
As legislative and judicial discussions continue, updates will be provided on state limitations on PBM practices and their impact on employer-sponsored health plans.