Iowa Regulator Seeks Clarity on Entities Impacted by PBM

On Oct. 14, Wellmark Blue Cross and Blue Shield filed a federal lawsuit against Iowa Insurance Commissioner Doug Ommen, challenging his enforcement of SF 383. Wellmark argues that the law violates ERISA and imposes burdensome costs and administrative requirements on health plans. The insurer’s legal action follows a previous lawsuit filed by the Iowa Association of Business and Industry (ABI) as well as other plaintiffs, which led to a preliminary injunction blocking enforcement of key provisions of SF 383 for the named plaintiffs only.

Wellmark now seeks similar protections for its own members and affiliates, arguing that the law’s enforcement would unfairly raise prescription drug costs for over one million Iowans. In parallel, the Iowa Insurance Division (IID) requested detailed information from PBMs regarding their clients’ membership status in ABI. This request stems from the court’s injunction, which applies only to ABI members and their contractors. The Division’s inquiry aims to clarify which entities are covered under the injunction and which remain subject to enforcement. The Iowa Pharmacist Association has advised its members to file complaints with the IID regarding non-compliance with SF 383. Commissioner Ommen has acknowledged receiving complaints and emphasized enforcement will be complaint-driven.