I just saw this. I wonder if this will have any implications on the Mandatory Specialty model that has been prevalent.
Vital Care of Meridian, a franchise of Vital Care Inc., (“Vital Care”) has won a significant partial summary judgment motion in a matter against the Mississippi State and School Employees’ Life and Health Plan (the “Plan”), a state insurance plan that covers certain state employees, and its pharmacy benefit manager (“PBM”). The lawsuit is currently in progress on remaining issues, but a major issue in the lawsuit was whether Mississippi’s “Any Willing Provider” statute (“Statute”) applies to the Plan. The Plan and the PBM awarded sole provider status for specialty pharmacy services to a single specialty pharmacy, to the exclusion of Vital Care and other specialty pharmacies in Mississippi. The Plan and its PBM argued that the Statute did not apply to them for a variety of reasons, but those arguments were rejected by the Mississippi Chancery Court. It is thought that this case will likely serve as precedent for several other similar cases across the country. (Court Order)
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