The plaintiff appeals the dismissal of its claims alleging that the Preferred Pharmacy Rule allows a Prescription Drug Plan to create a scheme that excludes independent pharmacies from participating in preferred pharmacy networks in direct contravention of the "any willing pharmacy" requirement. Caselaw interpreting the application of 42 USC §405(h) to Medicare claims emphasizes that the Illinois Council exception is extremely narrow and appropriately applied only in cases where judicial review would be entirely unavailable through the prescribed administrative procedures. The district court's dismissal order is affirmed. 5th U.S. Circuit Court of Appeals, No. 12-40097, 05-01-2013.
Southwest Pharmacy Solutions Inc. v. Centers For Medicare and Medicaid Services
May 6, 2013