U.S. Supreme Court

States are asking for the ability to regulate pharmacy benefit managers even when the PBMs are serving self-funded employer health plans.

2. Braidwood Management et al. v. Xavier Becerra, secretary of Health and Human Services, et al.

U.S. Supreme Court

The Supreme Court has already ruled on how federal regulators implementing birth control coverage mandates should handle employers with religious objections. Now, religious employers are asking whether the federal government can make them comply with benefits mandates unrelated to birth control, such as requirements for plans to put drugs that prevent HIV transmission in the basic Affordable Care Act preventive services package.

3. Kadel et a. v. Folwell et al.

U.S. Supreme Court

All of the judges on the 4th U.S. Circuit Court of Appeals — not just a three-judge panel — heard the case. They ruled that a North Carolina state employee health plan decision and a West Virginia Medicaid program decision not to cover some types of gender-related care were discriminatory.

4. Texas Medical Association et al. v. U.S. Department of Health and Human Services

5th U.S. Circuit Court of Appeals

The appeals court overruled a district court, sided with the federal government and found that the federal government has been using a valid process to resolve concerns related to disputes over medical bills under the federal No Surprises Act.

5. Knudsen et al. v. MetLife Group

3rd U.S. Circuit Court of Appeals

A three-judge panel ruled against employees who objected to what they said was their employer's failure to put $65 million in drug rebates it received from 2016 through 2021 in the employee health plan.

6. Blue Cross/Blue Shield Multidistrict Litigation

U.S. District Court for the Northern District of Alabama

The Blue Cross and Blue Shield carriers agreed to pay $2.8 billion to resolve an antitrust case but continued to deny the plaintiffs' allegations.

7. Insulin Pricing Litigation

U.S. District Court for the District of New Jersey

This multidistrict action is helping employers' self-funded plans and other parties object to the high cost of insulin.

8. Express Scripts et al. v. Federal Trade Commission

U.S. District Court for the Eastern District of Missouri

Large pharmacy benefit managers filed this suit to object to the FTC's allegations that they rigged the pharmaceutical supply chain to drive up insulin prices.

9. Barbara Baker et al. v. 7-Eleven

U.S. District Court for the Western District of Pennsylvania

Baker is seeking to represent a class of workers who object to how some employer plans impose surcharges on tobacco users. The workers say the plans should use the surcharges as an incentive for workers to do more to stop smoking, not to punish or discriminate against smokers.

10. Hahn et al. v. Vision Service Plan

U.S. District Court for the Northern District of Illinois

The consumer plaintiffs say a vision plan provider used a hidden pixel on its website to track how they moved through the site.