as this court recogniz and the case law is clear that states can't dictate to benefit plans how they determine how they structure their benefits or just what benefits they provide howley actually provide that and that's what th disclosing information and that's certainly within what states have always regulated well you know depends upon what the issue is if the if so we shouldn't we've been very clear about what we're challenging so if it's disclosure about an activity agree to the pharmacy the the plan's terms and conditions that provisional is applying what lodge is sufficient alone to reverse an inner judgment from the cia in addition we have the are fundamentally different than the state laws of this court considered in your heart and rutledge those laws regulate it the methodology that plans and to calculate drug benefit reimbursements they were said to apply in certain reason greater washington board is of no help to p c i may i think the reference to test that issue here is straightforward but these laws do not apply exclusively to interests of plant so what essentially arguing over is whether or clearly a fact a risk of plans especially refers to rd party payors doesn't it refers to rd party players that can be anyone it can be in a rest of plan and not a resupply on but many are going to be a risk a plan take the panels at their word that in those cases in certain instances the plans applied the law applied only to a risk of plants and if you're looking for a nd basis to factually distinguish those cases in each of those cases the laws made in reference to health benefit plans that was in prevention and that was in care heart and in rutledge mean a reference to pharmacy benefit plans there is no reference to plans at issue in doesn't relate to arrest you have a st says rd party payers and that's anything in the world in entity in the world except a patient health care provider that has to go to resupply i'm sure and that can't be able to test your honor because every law of court said that's not enough but a recent reference to preemption doesn't apply because the law is broad enough that it includes both arrests and non arrest and rutledge says there's no explicit reference in that case yet not in that case distinguish greater washington board of trade and that is to say that if a state law imposes requirements but very dependent on the presence of in orissa plan then it's prevented but here you don't have that problem if i can't persuade you really at the end of the day what this panel has to decide is whether or not to rape prevention your heart and rutledge in harmony with supreme court precedent and i think there are ways to do that i think this panel can take those decisions at their word that those laws applied in certain instances only to resupply hands and that they included references to health benefit plan in front of the benefit plan that are not at issue whether you consider the most applicable supreme court press to this case i think dillingham and travelers are certainly a political precedence and then to understand sort of the other side of the book and greater washington board of trade and i think the key in that latter that the from the cases are clear having a  that don't vary depending on the presence of an arrest a plan the supreme court's review of rutledge did with the result of that case have an impact on the issues before this certainly piece a maze interpretation of reference or preemption yes i think a forbidden connection with arista must govern a central matter of planet ministration or interfere with uniform planet ministrations i'll give you two examples of that if a state law required an aggressive plan to cover a particular drug or if it override of the plans determination of who's eligible for coverage those would be examples of interfering with plan administration but the north dakota laws don't do anything of the sort they regulate the practice of a pharmacy including what information a pharmacist may disclose to patients what drugs a pharmacist may dispense may authorize pharmacists that dispense by mail they ran for state licensing and accreditation standards and they limit opinions ability to engage in self dealing and name they impose restrictions on certain fees unrelated to drug benefit reimbursements so the laws additional here are fundamentally different than those that issuing your heart that are regulated and interfered with the methodology that members are interested in these kinds of conversations they're very interested in price affan times charge a higher amount than a plan number could obtain if they paid out of pocket for a drug and under the current regime set up the pharmacist precluded from having that conversation with the patient that has nothing to do what with plan administration and what i will direct you to on the connection with prong is that congress anticipated that there would be  and the presumption against preemption but holding a rock ledge is the holding of rutledge it was necessary to the decision in that case so you had to have a standard under party an overlap with a state standard and even if you want to ignore that and claim that it's not a holding it's contrary to the text of the statute the statute is tied to the existence of federal standards that supersede state law acting with respect to a party plan we do not believe that the congress intended for each and every state requirement applying to part d plans to become null and void but probably got the agency what's the status of the savings close in this case sure so that there are two clauses  read me every word with medicine and medical services one of the words with health services includes the protext the provision of health services thank you very much percy now when congress an active part issue is not in an affirmative defense it's an issue of whether or not there are still preemption and typically a big proponent of preemption bears the burden of establishing as much there's no pleading requirement as they can see it in a raise the argument in a cross motion for summary judgment it wasn't relevant to the district court's decision because the district court held that the laws were not preempted at all it's also not an alternative basis for affirmative because it doesn't result price payment terms and peace amy's argument are that class is flawed because the noninterference clause is principally a limitation on the federal government so if you accept their argument that the noninterference relates to non payment term permissible as reasonable and relevant state practice standards at the end of the day what p c m is argument here is for preemption other rests in medicare even in those areas where the statutes have nothing to say and as justice thomas s state over and over and over again that this is a regulation of pharmacies and this is the north dakota challenge that you're to involve licensing pharmacies that's act that's just incorrect  statutes regulate they have facts from the farmers can from says can take the benefit of it and i would like for up proposition we put this in our brief circus association of health plans or says miller which deals with the insurance