Southwest Pharmacy Solutions, Inc. D/B/A American Pharmacies v. Texas Health and Human Services Commission and Thomas Suehs, Solely in His Official Capacity as Executive Commissioner of the Texas Health and Human Services Commission
Southwest Pharmacy Solutions, Inc. d/b/a American Pharmacies appealed a trial court's judgment granting a plea to the jurisdiction filed by the Texas Health and Human Services Commission (HHSC) and its Executive Commissioner. American Pharmacies challenged HHSC's rulemaking obligations and specific rules related to pharmacy benefits under the Texas Medicaid managed care (MMC) program. They argued that HHSC failed to regulate reimbursement rates for pharmacies and did not comply with statutory requirements for analyzing the economic impact on small businesses. The appellate court affirmed the trial court's judgment, concluding that HHSC was not obligated to set reimbursement rates under the MMC model and had substantially complied with the relevant government code regarding small business impact. The court also determined that American Pharmacies lacked a justiciable interest as their economic losses stemmed from legislative changes rather than the challenged rules.