In Thole v. U.S. Bank, N.A., 140 S Ct. 1615 (2020), the Supreme Court, in a five to four decision authored by Justice Kavanaugh, held that participants in an ERISA defined benefit pension plan did not have standing under...more
8/16/2023
/ Article III ,
Breach of Duty ,
Defined Benefit Plans ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Injury-in-Fact ,
MetLife ,
MEWAs ,
Mismanagement ,
Pensions ,
Pharmacy Benefit Manager (PBM) ,
Plan Participants ,
Retirement Plan ,
SCOTUS ,
Standing ,
Thole v U.S. Bank
We usually focus most on significant ERISA court decisions, particularly those from the Supreme Court, that clarify important open legal issues under ERISA. However, some ERISA court decisions simply serve as important...more
The Consolidated Appropriations Act, 2021 (CAA) generally requires group health plan sponsors to request and review fee information from their plan service providers who provide brokerage services or consulting. This fee...more
Last December, the U.S. Supreme Court unanimously held that provisions of an Arkansas law that regulated the use by pharmacy benefit managers (“PBMs”) of maximum allowable cost programs to limit retail pharmacy reimbursement...more
Recent court trends suggest that preemption under the Employee Retirement Income Security Act (ERISA) may not apply to certain state laws that regulate pharmacy benefit managers (PBMs), including state laws governing Maximum...more
6/16/2021
/ Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Prescription Drug Coverage ,
Prescription Drugs ,
Rutledge v Pharmaceutical Care Management Association ,
SCOTUS
Recently, a three-judge panel in the Court of Appeals for the Ninth Circuit overturned a district court dismissal of an out-of-network provider’s claims against Blue Cross and Blue Shield of Illinois (“BCBSIL”). The unanimous...more
In January, the Supreme Court agreed to accept an appeal filed by the State of Arkansas of a decision by the Eighth Circuit Court of Appeals finding that Section 514 of ERISA expressly preempted the state’s maximum allowable...more