Drug Middlemen Shift Arguments to Escape Liability, State Laws

Courts have been letting powerful pharmacy drug middlemen use federal protections for employee benefit plans as both a sword and a shield.

Pharmacy benefit managers, which administer drug benefit programs in employee health plans, have won cases in recent months by using the Employee Retirement Income Security Act (ERISA) to wipe out state regulations and escape liability for plan losses. PBMs have been enjoying the benefits of the law without paying the costs, attorneys say.

OptumRx, a subsidiary of UnitedHealth Group; CVS Caremark, a subsidiary of CVS Health; and Express Scripts, a subsidiary of Cigna Corp., are the three largest ...