Benefit-manager group to appeal ruling on Rx-law

Measure ensures pharmacies reimbursed when prices shift

A national group filed a notice Monday in federal court in Little Rock that it intends to appeal the March 1 dismissal of its lawsuit challenging a 2015 state law supported by pharmacists.

Act 900 of 2015, which took effect on July 22, 2015, requires benefits managers for insurers and health plans to reimburse pharmacies at or above the cost a pharmacy paid for generic drugs from a wholesaler. Pharmacists said the law was necessary to stop benefits managers from shorting them on reimbursements by using Maximum Allowable Costs lists, which often use outdated prices.

The Pharmaceutical Care Management Association, a Washington, D.C.-based national trade group, contended the Arkansas law requires benefits managers to set up a different reimbursement system just for Arkansas, and disrupts the uniformity that the costs lists provide for pharmacy networks across the country. The Pharmaceutical Care Management Association also alleged that the law allows pharmacists to make more money at the expense of benefits managers, which will result in higher costs for plans and patients.

On March 1, Chief U.S. District Judge Brian Miller threw out the association’s lawsuit, filed in 2015, noting that the Arkansas Legislature passed the law to address growing financial hardships faced by independent community pharmacies. Miller also said that he believed the state law didn’t interfere with federal law — specifically, the Employment Retirement Security Act of 1974. But he also said the 8th U.S. Circuit Court of Appeals had reversed a similar ruling by a judge in Iowa.

Noting that he was trying to conform with the 8th Circuit opinion, Miller indicated that he reluctantly agreed with the Pharmaceutical Care Management Association that Act 900 is invalid in one sense, when applied to the managers’ administration and management of ERISA plans. But he said the Arkansas law isn’t pre-empted by Medicare Part D.

Like the Iowa case, the appeal in the Arkansas case will be decided by the 8th Circuit.