Clarity Of Insurer, PBM Price-Setting Decision Disputed In Review Row

Mealey's (June 6, 2022, 12:45 PM EDT) -- WASHINGTON, D.C. — In a May 24 amicus curiae brief, the federal government argues that the reasoning “is not entirely clear” in a nonprecedential Second Circuit U.S. Court of Appeals ruling that a health benefits provider and a pharmacy benefits manager (PBM) were not acting as fiduciaries under the Employee Retirement Income Security Act when they set prescription drug prices and that even if the Second Circuit erred, review by the U.S. Supreme Court is not warranted; in a June 3 supplemental brief, the petitioners counter that the government “offers five reasons to sweep this pernicious error under the rug.”...