Express Scripts, PCMA Sue Tennessee Over Law Requiring PBM-Pharmacy Separation
Express Scripts and the Pharmaceutical Care Management Association filed lawsuits challenging Tennessee's FAIR Rx Act, which mandates the separation of pharmacy benefit managers from retail pharmacies. The law, passed earlier this year over strong PBM industry opposition, aims to prevent vertical integration practices that critics argue drive up drug costs and limit pharmacy access. The litigation follows similar legal action by CVS Caremark. The outcome will affect how Medicaid managed care plans structure pharmacy benefits and contract with PBMs in Tennessee and potentially influence similar legislative efforts in other states.
Most Medicaid MCOs contract with national PBMs for pharmacy benefits management, and vertical integration restrictions could force contract restructuring, affect pharmacy network adequacy requirements, and alter drug pricing arrangements.
Pharmacy · Managed Care
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