Seventh Circuit Weighs Arkansas Law on Health Plan Pharmacy Payments

April 14, 2026, 5:29 PM UTC

A three-judge panel on Tuesday heard arguments in a case challenging an Arkansas law regulating pharmacy payments brought by a regional chapter of the International Brotherhood of Teamsters.

At issue is Arkansas Rule 128, requiring health plans to report fees they pay to pharmacies through their pharmacy benefit managers. The rule also gives Arkansas’s insurance commissioner the power to increase payments if he or she decides they’re insufficient.

The case is the second high-profile battle Arkansas has waged against pharmacy benefit managers following the state’s 2020 US Supreme Court victory in Rutledge v. Pharmaceutical Care Management Association. A ...

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