The Pharmaceutical Care Management Association, a trade group for pharmacy benefit managers, filed lawsuits in June challenging Illinois and Tennessee pharmacy laws.
PCMA raised Employee Retirement Income Security Act-based preemption counts targeting Illinois’ Prescription Drug Affordability Act. The law, signed in 2025, bans spread pricing and steering patients to pharmacies owned by the PBM. The lawsuit, filed in Illinois federal court, specifically challenged the law’s reporting, anti-steering and network design provisions. The complaint claimed reporting requirements will prompt steep administrative costs and steering restrictions infringe on plan design.
One day prior, PCMA joined major PBMs, most recently Cigna’s Express Scripts, in contesting the Freedom, Access and Integrity in Registered Pharmacy Act, also known as the FAIR Rx Act.
Starting in July 2028, Tennessee will not permit a company from holding more than a 5% ownership interest in a pharmacy, as well as a health insurance issuer and pharmacy benefit manager. There is a grace period through the end of 2028 for companies meeting this criteria, but only if the pharmacy can show the state that it is planning a sale.
A complaint filed in a Tennessee federal court claimed the in-state PBM run by local pharmacists, RxPreferred Benefits, was carved out, even though it “presents the same supposed conflict of interest that the act purports to address.” The lawsuit alleged a commerce clause violation, as well as preemptions by Medicare and ERISA policies.
The Illinois Department of Insurance and Tennessee’s attorney general told Becker’s they could not comment on litigation. Becker’s also contacted the Tennessee Department of Health Board of Pharmacy and will update this story if more information becomes available.
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