McKee Foods Corp. v. BFP Inc.

CourtCourt of Appeals for the Sixth Circuit
DecidedMarch 21, 2024
Docket23-5170
StatusUnpublished

This text of McKee Foods Corp. v. BFP Inc. (McKee Foods Corp. v. BFP Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McKee Foods Corp. v. BFP Inc., (6th Cir. 2024).

Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 24a0137n.06

Case No. 23-5170

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

FILED MCKEE FOODS CORPORATION, ) Mar 21, 2024 ) KELLY L. STEPHENS, Clerk Plaintiff-Appellant, ) ) ON APPEAL FROM THE v. ) UNITED STATES DISTRICT ) COURT FOR THE EASTERN BFP, INC dba Thrifty Med Plus Pharmacy, ) DISTRICT OF TENNESSEE Defendant-Appellee, ) ) OPINION STATE OF TENNESSEE, ) Intervenor-Appellee. ) )

Before: McKEAGUE, READLER and DAVIS, Circuit Judges.

DAVIS, Circuit Judge. McKee Foods Corporation (“McKee”) maintains that appellee

BFP, Inc. d/b/a Thrifty Med Plus Pharmacy (“Thrifty Med”) has engaged in a three-year campaign

to get reinstated into McKee’s Prescription Drug Program (“PDP”) pharmacy network—a

campaign that has included Thrifty Med filing multiple administrative complaints against McKee

and actively lobbying to change Tennessee pharmacy laws in its favor. McKee filed this lawsuit,

seeking a declaratory judgment and injunctive relief to prevent Thrifty Med from attempting to

rejoin its PDP pharmacy network. Specifically, McKee seeks to clarify that Tennessee’s “any

willing pharmacy” (“any-willing-pharmacy”) laws are preempted by the Employee Retirement

Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (“ERISA”), and that state law does not

require it to include Thrifty Med in its approved network of pharmacies. The district court No. 23-5170, McKee Foods Corp. v. BFP, Inc.

dismissed the suit for lack of subject matter jurisdiction, holding that McKee’s claims were

rendered moot following changes to the underlying state laws and other factual developments in

the case. We conclude, however, that McKee’s complaint is not moot. Therefore, we VACATE

the district court’s decision and REMAND for further proceedings.

I.

Factual Background. McKee Foods is a commercial bakery in Tennessee that offers a

health benefits plan (“Health Plan”), governed by ERISA, for its eligible employees and their

eligible dependents. Health Plan benefits are funded by contributions from McKee Foods and plan

participants. One of the many advantages of membership in the Health Plan is access to its

Prescription Drug Program (“PDP”). The PDP grants more favorable benefits when participants

purchase prescription drugs from in-network pharmacies as compared to out-of-network

pharmacies. As co-administrator of the PDP, McKee actively determines which pharmacies are

part of the Program’s approved network of pharmacies.

Thrifty Med, an independent pharmacy in Tennessee, was formerly a member of the PDP’s

in-network pharmacies. However, an audit of Thrifty Med’s practices revealed that some of its

operations were, in McKee’s view, inconsistent with the Health Plan’s terms. The audit results

led McKee and its third-party pharmacy benefits manager (“PBM”) to remove Thrifty Med from

its PDP network in July 2019. Unhappy with its removal from the PDP network, Thrifty Med took

several measures to try to gain its reinstatement. For instance, Thrifty Med’s owners sought and

obtained multiple meetings with McKee; circulated petitions amongst McKee employees for them

to express support for Thrifty Med’s reinstatement; commissioned multiple large billboards in

service of their cause; and enlisted their attorney to send letters to McKee’s counsel, invoking

Tennessee’s any-willing-pharmacy statute to support its call for reinstatement. Thrifty Med’s

-2- No. 23-5170, McKee Foods Corp. v. BFP, Inc.

owners also sent several emails and texts directly to Tennessee representatives to lobby for the

passage and ratification of PC 569.1

Eventually, Thrifty Med sensed a shift of Tennessee law in its favor. A brief overview of

the sequence of changes in Tennessee pharmacy law over the relevant period will aid in our

analysis. Following the May 2021 passage of Public Chapter 569 (“PC 569”), the Tennessee

legislature enacted Tenn. Code Ann. § 56-7-3120(b) (“§ 3120(b)”) and prescribed new rules for

prescription drug programs. With an effective date of July 1, 2021, the text of PC 569 read as

follows:

(b) A pharmacy benefits manager or a covered entity shall not interfere with the patient’s right to choose a contracted pharmacy or contracted provider of choice in a manner that violates § 56-7-2359 or by other means, including inducement, steering, or offering financial or other incentives.

Tenn. Code Ann. § 56-7-3120(b) (2021). In turn, Tenn. Code § 56-7-2359, first enacted in 1998,

is informally known as the “any-willing-pharmacy” law and requires insurers to include all

pharmacies as a provider if the pharmacy agrees to the terms and conditions of the plan. Reeves-

Sain Med., Inc. v. BlueCross BlueShield of Tenn., 40 S.W.3d 503, 505 (Tenn. Ct. App. 2000). PC

569 created a new remedy for the existing any-willing-pharmacy law that would subject any

covered entity that did interfere with the rights provided under § 56-7-2359, to a range of penalties

(e.g., license revocation, civil penalties, etc.) imposed at the discretion of the Commissioner of the

Tennessee Department of Commerce and Insurance (“TDCI”). See Tenn. Code §§ 56-2-305(a),

56-7-3110.

Notably, PC 569 relied on the existing definition of “covered entity” within Tennessee law,

which, among other groups, included “self-insured entities” like McKee. Tenn. Code Ann. § 56-

1 Thrifty Med’s owners also lobbied Tennessee legislators and Governor Bill Lee for the passage of the PC 569’s successor bill, PC 1070.

-3- No. 23-5170, McKee Foods Corp. v. BFP, Inc.

7-3102(1) (2021). The term “covered entity” made no express reference to ERISA plans. But, on

July 8, 2021, the TDCI issued a bulletin clarifying that “covered entities” “includes ‘self-insured

entities,’ which would include ERISA plans” and that “[n]o exclusions in the PBM laws are carved

out to exclude plans currently regulated by ERISA.” (R. 36-4, PageID 299–300). The bulletin

concluded that “[t]he Department will enforce Pub. Ch. 569 accordingly.” (Id. at 300).

Based on PC 569’s revisions to Tennessee law and the clarifying statements issued by the

TDCI, Thrifty Med took the position that this new state law required McKee Foods to include

Thrifty Med as an in-network pharmacy. Thrifty Med then picked up its pursuit of reinstatement

to McKee’s PDP network by submitting claims for payment for services it had rendered to Health

Plan members. When McKee denied those claims, Thrifty Med filed three administrative

complaints with the TDCI dated September 13, October 12, and October 18, 2021, respectively.

The relief sought in each complaint was reinstatement to McKee’s PDP network. However, the

administrative complaints were short-lived; the TDCI dismissed them in letters dated October 27,

November 2, and November 30, 2021, respectively.

Procedural History. Roughly two weeks before the TDCI disposed of the last

administrative complaint, McKee commenced this litigation. Its three-count complaint seeks:

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