(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) released the following statement on the United States Supreme Court’s decision to decline review of the 2023 ruling by the U.S. Court of Appeals for the Tenth Circuit in PCMA v. Mulready. The decision by the high court solidifies PCMA’s successful challenge to four provisions of a misguided Oklahoma state law by finding them to be preempted under the Employee Retirement Income Security Act of 1974 (ERISA) and the Medicare Part D program.

“We applaud the Supreme Court’s decision to decline review,” said Jack Linehan, General Counsel, PCMA. “As the Mulready case reaffirms, ERISA and the Medicare Part D statute are the primary laws governing health care benefits organized under these federal frameworks. In particular, ERISA preemption has been the cornerstone of the American system for employer-sponsored health care benefits, and it is vital to maintain the statute’s authority to allow plan sponsors to administer uniform health benefits across state lines and control costs for their workers.”

The Oklahoma law would have specifically restricted pharmacy benefit managers (PBMs) and health plans from designing quality-enhancing and cost-reducing pharmacy networks that advance plan affordability and choice. By finding these provisions to be preempted, the Tenth Circuit preserves the ability of U.S. employers, unions, and Part D plan sponsors to design and administer health benefits in the way that best meets the needs of employees, seniors, and their families.

Additionally, the Tenth Circuit decision cautions against illegal state interference with the federal Medicare program, which can boost costs and restrict choices for Part D plans and American seniors. The decision helps to preserve cost-efficient prescription drug benefit design for Part D plans while shielding Medicare program finances.

“The Tenth Circuit demonstrated a keen understanding of health benefits and the law and ultimately reached the correct conclusion,” said Kristyn DeFilipp, Foley Hoag LLP. “With today’s decision, workers and older adults in the Tenth Circuit can rest assured that their benefits will be protected from state law overreach.”

###

PCMA is the national association representing America’s pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 289 million patients.