News/Blogs

The second quarter of 2025 brought notable regulatory and legal developments impacting pharmacy benefits, PBMs, and health care access. Court decisions shaped much of the landscape, while state legislatures and federal agencies continued to drive scrutiny around drug pricing and PBM practices.

At Serve You Rx, we track these shifts closely so you can focus on supporting your clients. Below is a summary of the key updates that stakeholders should be aware of as we move through 2025.

Litigation Highlights

• A federal judge in Texas vacated most provisions of the 2024 HIPAA Rule to Support Reproductive Health Care Privacy. The rule created special requirements for reproductive health care information, finding that the U.S. Department of Health and Human Services exceeded its statutory authority.
  
• The U.S. Supreme Court upheld the Affordable Care Act (ACA), allowing the U.S. Preventive Services Task Force to continue determining which services must be covered without cost-sharing for individuals covered by the ACA.
  
• The U.S. Supreme Court declined to review PCMA v. Mulready, leaving in place a ruling that ERISA and the Medicare Part D program preempt four provisions of an Oklahoma law.
  
• A federal court in Arkansas issued a preliminary injunction blocking the enforcement of Arkansas Act 624. The act bars PBMs from owning or operating pharmacies in the state. The injunction applies to the plaintiffs in the case.
  
• A federal court in Iowa issued a preliminary injunction blocking enforcement of Iowa’s PBM restrictions after a group of businesses sued. The court found ERISA likely preempts the law and violates the First Amendment. The injunction applies to the plaintiffs in the case.

Federal Events

• The FTC held listening sessions related to drug pricing, inviting expert panels to speak and address questions submitted by the public. The topics included pharma patent abuses and PBM practices.
  
• On July 31, 2025, President Trump notified leading pharmaceutical manufacturers of steps required to lower U.S. prescription drug prices. This aligns with the administration’s original most-favored-nation plan. Letters were sent to AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, EMD Serono, Genentech, Gilead, GSK, Johnson & Johnson, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron, and Sanofi.

State Laws and Regulations

• States have passed more than 120 laws affecting pharmacy benefits and/or pharmacy benefit manager practices in the self-insured space.
  
• Illinois​ HB 1697 includes bans on spread pricing and steering, and creates a $15 per covered life fee paid by the PBM. The law also establishes a grant program to distribute $25 million annually in financial support for independent pharmacies.
  
• Alabama, Iowa, Indiana, and Louisiana enacted laws or regulations to mandate reimbursement amounts for pharmacies. This reflects a growing trend in state legislation to set specific reimbursement amounts.

About Serve You Rx®   
Serve You Rx is a full-service pharmacy benefit manager (PBM) with unquestionable flexibility and an unwavering commitment to doing what's best for its clients. With a fervent focus on those it serves, including insurance brokers, consultants, third-party administrators, and their clients, Serve You Rx delivers exceptional service and tailored, cost-effective benefit solutions. Independent and privately held for nearly 40 years, Serve You Rx can implement new groups in 30 days or less and say "yes" to a wide variety of viable solutions. Known for its adaptability, quality, and client-centricity, Serve You Rx aims to be a benchmark for better client service.