Pharmacy benefit managers have been in the crosshairs of enforcement and reform efforts for several years. At the federal level, the Federal Trade Commission has obtained favorable settlements for the government, and Congress passed PBM reform in the Comprehensive Appropriations Act in February. Some states have also enacted their own legislation, which has become the latest battleground as PBMs level constitutional challenges to state efforts to regulate PBMs’ limitations on where and how patients can fill prescriptions. The outcome of these challenges may dictate whether other states take similar action, and whether PBM influence on pharmacy selection continues to grow.

To continue reading Amy N. Vegari and Sarah Brand Wasson's article in The National Law Journal, please click here.