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Page Number: 4.0

Cite as:  592 U. S. ____ (2020) 

1 

Opinion of the Court 

NOTICE:  This opinion is subject to formal revision before publication in the 
preliminary  print  of  the  United  States  Reports.  Readers  are  requested  to 
notify the Reporter of Decisions, Supreme Court of the United States, Wash-
ington, D. C. 20543, of any typographical or other formal errors, in order that 
corrections may be made before the preliminary print goes to press. 

SUPREME COURT OF THE UNITED STATES 

_________________ 

No. 18–540 
_________________ 

LESLIE RUTLEDGE, ATTORNEY GENERAL OF 
ARKANSAS, PETITIONER v. PHARMA- 
CEUTICAL CARE MANAGEMENT 
ASSOCIATION 

ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF 
APPEALS FOR THE EIGHTH CIRCUIT 

[December 10, 2020] 

  JUSTICE SOTOMAYOR delivered the opinion of the Court. 
  Arkansas’ Act 900 regulates the price at which pharmacy 
benefit  managers  reimburse  pharmacies  for  the  cost  of 
drugs  covered  by  prescription-drug  plans.    The  question 
presented in this case is whether the Employee Retirement 
Income  Security  Act  of  1974  (ERISA),  88  Stat.  829,  as 
amended, 29 U. S. C. §1001 et seq., pre-empts Act 900.  The 
Court holds that the Act has neither an impermissible con-
nection  with  nor  reference  to  ERISA  and  is  therefore  not 
pre-empted. 

I 
A 
  Pharmacy  benefit  managers  (PBMs)  are  a  little-known 
but important part of the process by which many Americans 
get  their  prescription  drugs.    Generally  speaking,  PBMs 
serve  as  intermediaries  between  prescription-drug  plans 
and the pharmacies that beneficiaries use.  When a benefi-
ciary of a prescription-drug plan goes to a pharmacy to fill