U.S. District Judge Eli Richardson on Tuesday consolidated four lawsuits filed over the Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act, unifying claims made by nearly 60 plaintiffs over Tennessee’s prohibition on vertical integration of pharmacy benefit managers (PBMs) and pharmacies.
Richardson, an appointee of President Donald Trump, ruled that four lawsuits designed to reverse Tennessee’s new law “have common questions of law and fact,” meaning their “consolidation would promote the economy and convenience of the Court and of the parties.”
The lawsuits were filed by CVS, which leads 29 entities; Express Scripts, alongside 11 other entities; UnitedHealth, with 16 more entities; and the Pharmaceutical Care Management Association (PCMA). A total of 57 plaintiffs are represented in the four different legal actions.
Consolidating the lawsuits, Richardson also set a unified case-management schedule, setting deadlines for responsive pleadings, discovery, and dispositive motions from August through December.
The lawsuits filed by Express Scripps, PCMA, and UnitedHealth appear to contain many of the allegations in the litigation brought by CVS, which alleges Tennessee is violating the dormant Commerce Clause of the U.S. Constitution, illegally preempting Medicare Advantage and Part D prescription networks, preventing multi-state employers from creating company-wide benefit plans, and violating of the Takings Clause in the Constitution, as they claim the law effectively destroys or appropriates the value of CVS stores in Tennessee.
Express Scripts’ lawsuit additionally alleges the law will disrupt a Memphis specialty pharmacy, national-order services, and fertility pharmacies, all related to TRICARE, the health benefits provider for active-duty service members, retirees, and their families. The PCMA lawsuit appears to emphasize the claim that Tennessee favors in-state pharmacies over companies based in other states.
While Governor Bill Lee signed the FAIR Rx Act into law in May, the law includes a transition period and staggered enforcement dates.
On July 1, the Tennessee Board of Pharmacy was required to assess every active pharmacy license in the state. By October 1, the board must notify license holders if they are determined likely to violate the new law. Those pharmacies must notify any patients who visited the pharmacy within the past 12 months by November 1.
Companies deemed in violation of the FAIR Rx Act will be allowed to operate until December 31 if they can prove they are pursuing a sale to a buyer who will comply with the law. By January 1, 2027, the pharmacies must be sold or shut their doors.
Proponents of the law say it will lower prescription drug prices for Tennesseans, but critics have warned it will make it more difficult for veterans and those in rural parts of the state to access prescription drugs. Others have argued it could undermine TrumpRx, the drug pricing initiative championed by the Trump administration.
A similar law was passed in Arkansas last year. It has since been blocked by a Trump-appointed federal judge.
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Tom Pappert is a 2025 recipient of the Dao Prize and the lead reporter for The Tennessee Star. He also reports for the Star News Network. Follow Tom on X. Email tips to [email protected].
