Groom principal Ryan Temme joined Law360 to discuss the impact pharmacy benefit managers (“PBMs”), plans, and plan service providers may face following conflicting rulings from a Texas federal court that invalidated the Food and Drug Administration’s (“FDA”) approval of an abortion pill and, shortly thereafter, a Washington court ruling ordering that the FDA continue offering the pill. The Texas ruling has the potential to limit legal access to a pill used to terminate pregnancies in Texas and could create confusion for PBMs and plans that operate more broadly.
Law360 reported that Temme “said the Texas decision highlighted the role of PBMs in administering and implementing different plan designs.”
“Plans and plan service providers are faced with evaluating the risks of both criminal and civil liability with respect to abortion-related benefits,” Temme explained.
“For the majority of plan benefits, those types of pressures are not typically in place from a state law perspective,” he added. “It’s sort of an operational headache. And then it obviously pulls the PBMs into some of the political dynamics that we see unfolding right now with the pharmacies.”
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