"For now, we know that Rutledge does not preempt PBM regulations that merely increase the cost of doing business in the state. Mulready preempts plan design requirements, including network adequacy, in PBM laws in the 10th Circuit, but network considerations are likely not preempted pursuant to Wehbi in the 8th Circuit. Finally, Gobeille provides an argument that ongoing reporting and attestations are preempted.... [T]he only thing that is clear is that PBM laws that merely increase plan costs, without more, are not preempted. Most other types of provisions ... are still up for debate."  MORE >>