State efforts to regulate pharmacy benefit managers are colliding with federal law, reviving a power struggle over who can police the companies that manage drug benefits for most Americans. The states are trying to rein in the middlemen that negotiate drug prices and pay pharmacies, but they’re running into a federal law that has the final say over employer health plans. A federal appeals court last week ruled against Tennessee in a case over whether the state could require PBMs to partner with any pharmacy that’s willing to accept their terms and conditions. That followed rulings against PBM laws in Iowa and Oklahoma that courts found were preempted by the federal ERISA law.
Read the full article: States’ Efforts to Rein in PBMs Hit a Legal Roadblock //
Source: https://www.axios.com/2026/04/15/states-pbm-laws-falter-courts