On June 30, 2025, the United States Supreme Court declined to review the 2023 ruling in Pharmaceutical Care Management Association v. Mulready by the United States Court of Appeals for the Tenth Circuit (the 10th Circuit) over Oklahoma’s Patient’s Right to Pharmacy Choice Act (“the Act”), which regulates pharmacy benefit managers (PBMs) in the state.
The 10th Circuit’s Mulready decision reaffirmed ERISA preemption, which limits the ability of states to regulate self-insured ERISA plans. Specifically, the court determined ERISA preempts four provisions in the Act. The decision is only binding in the 10th Circuit (which includes Colorado, Kansas, New Mexico, Oklahoma, Utah, Wyoming, and portions of the Yellowstone National Park extending into Montana and Idaho). Mulready may influence PBM laws in other states, and the Supreme Court’s action to let the decision stand suggests it agrees with the 10th Circuit’s interpretation of ERISA preemption and state PBM laws affecting plan design and administration.
This alert provides a general overview of ERISA preemption and summarizes the 10th Circuit’s decision, with a focus on the Act’s provisions the court ruled ERISA preempts and what this means for plan sponsors with self-insured plans going forward. It is relevant for employers sponsoring self-insured group health coverage providing prescription drug benefits administered by a PBM.
