This week the Academy of General Dentistry (AGD) joined seven other healthcare organizations in filing an amicus curiae brief with the United States Supreme Court initiated by the American Dental Association (ADA). The organizations have come together to ask the Court to accept the case of Mulready v. Pharmaceutical Care Management Association (PCMA) for argument. The case deals with how broadly Employee Retirement Income Security Act (ERISA) preemption applies to state healthcare reform legislation. ERISA protections generally cover self-funded health insurance plans.

In 2019 Oklahoma passed a law regulating pharmacy benefit managers (PBMs). The Tenth Circuit ruled that ERISA pre-empted Oklahoma’s efforts to regulate PBMs. The AGD-signed brief argues that the Tenth Circuit’s decision ignores a Supreme Court case, Rutledge v. PCMA, that ruled that Arkansas could regulate PBMs without ERISA preemption. The brief argues that ERISA preemption should only apply to state laws that affect plan administration, not to laws that affect plan benefits.

Overturning the Tenth Circuit’s opinion in Mulready will help clarify that state health care reforms, like assignment of benefits, prior authorization, non-covered services, and anti-clawback laws, apply to all plans, even ERISA plans.

A group of 31 states plus the District of Columbia also filed an amicus brief asking the Supreme Court to accept the case for argument in support of Oklahoma’s position.  In the next few months, the Court will decide whether to take the case or let the Tenth Circuit ruling stand.