An Arkansas act requiring pharmacy benefit managers to reimburse pharmacies at a price equal to or higher than the pharmacy’s wholesale cost is not preempted by the Employee Retirement Income Security Act; state rate regulations that merely increase costs or alter incentives for ERISA plans without forcing plans to adopt any particular scheme of substantive coverage are not pre-empted by ERISA; ERISA plans are not essential to the state act’s operation since the act regulates PBMs whether or not the plans they service fall within ERISA’s coverage.
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