Cardinal Health
Managed Care
 

Dear Valued PSAO Member,

On December 12, the Supreme Court of the United States (SCOTUS) issued its landmark ruling in Rutledge v. Pharmaceutical Care Management Association (PCMA).

What does this mean for my pharmacy?

Before this ruling, it was unclear whether certain state laws regulating Pharmacy Benefit Managers (PBMs) were enforceable. The SCOTUS ruling will allow individual states to have greater flexibility to implement regulations regarding pharmacy reimbursement governed by the Employee Retirement Income Security Act of 1974 (ERISA), such as commercial and self-insured plans. For example, in the Rutledge case, SCOTUS upheld an Arkansas law requiring PBMs to reimburse pharmacies at a price equal to or higher than the price paid by the pharmacy to buy the drug from its wholesaler. The outcome of this case supports fair reimbursement for independent retail pharmacies who are dedicated to serving their communities, providing care services above and beyond medication dispensing.

What does this mean for the PSAO?

As with most legislative changes, it will take time for state regulatory bodies and payers to make changes. As your trusted partner, we remain steadfast in ensuring that our PSAO contracts reflect applicable regulations. We will monitor the effects of this ruling throughout the states as we believe fair reimbursement practices will benefit pharmacists and payers by allowing pharmacies to concentrate on the health of their patients.

Where can I obtain additional information and updates?

We encourage you to visit NCPA’s website for the latest information about this ruling. As your PSAO, we are actively involved with NCPA and continue to support their advocacy efforts.