Express Scripts v. Keith Wenzel

Civil case - ERISA. Missouri statutes - Mo. Rev. Stat. Sections 354.535.3 and 354.535.4 - regulating HMOs handling of prescription drug purchases are saved from preemption under ERISA because they regulate HMOs which are in the business of insurance.

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At issue in this case is whether certain provisions of Missouri law are preempted
by the Employee's Retirement Income Security Act of 1974 (ERISA). The provisions
regulate some aspects of how Missouri health maintenance organizations (HMOs)
provide prescription drugs through network pharmacies. Express Scripts, Inc.
(Express), which has a mail order pharmacy, and several business groups brought this
action for injunctive and declaratory relief against Keith Wenzel, the acting director of
the Missouri Department of Insurance, arguing that the Missouri provisions could not
be enforced because they were preempted by ERISA. After the district court 2 granted
Wenzel's motion for summary judgment, plaintiffs appealed and the United States
Secretary of Labor filed an amicus brief supporting one of Wenzel's theories for
affirmance.

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Click the case caption above for the full text of the Court's opinion.

We conclude that the challenged provisions fall within ERISA's savings
clause and therefore affirm.

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