Pharmaceutical Care Management Association v. Mylynn Tufte

Summary

The Eighth Circuit held that North Dakota's legislation regulating pharmacy benefits managers (PBMs) was preempted by ERISA because it impermissibly "referenced" ERISA plans through its definitions of "third-party payer" and "plan sponsor," making the existence of ERISA plans essential to the law's operation. Following prior circuit precedent (Gerhart and Rutledge), the court found that the statute implicitly regulated ERISA plans even though it also covered non-ERISA entities, and thus the entire legislation was preempted. The court did not reach Medicare Part D preemption issues and deemed the state's savings clause argument waived. The district court's partial denial of preemption was reversed, and the case was remanded for entry of judgment in favor of PCMA.

Holdings

1. The North Dakota legislation is preempted by ERISA because it has an impermissible 'reference to' ERISA plans through its definitions of 'third-party payer' and 'plan sponsor,' which make the existence of ERISA plans essential to the law's operation.
2. North Dakota has waived this argument because it was raised only in a footnote and not properly argued.

Questions Presented

1. Whether the North Dakota legislation is preempted by ERISA because it has an impermissible 'reference to' ERISA plans.

Disposition

reversed_and_remanded