Coalition for Common Sense in Government Procurement v. United StatesCoalition for Common Sense in Government Procurement v. United States
MEMORANDUM OPINION
On January 28, 2008, Congress enacted the National Defense Authorization Act for Fiscal Year 2008 (“NDAA-08”). Section 703 of NDAA-08 requires that pharmaceuticals paid for by the Department of Defense (“Department” or “DoD”) and provided through the TRICARE retail pharmacy program be subject to pricing standards known as Federal Ceiling Prices. The Department promulgated a final rule implementing section 703 on March 17, 2009. Under this rule, pharmaceutical manufacturers cannot receive more than the Federal Ceiling Prices for pharmaceuticals purchased by DoD for the retail pharmacy program, and must refund amounts in excess of the Federal Ceiling Prices for prescriptions filled on or after January 28, 2008. Plaintiff Coalition for Common Sense in Government Procurement (“Coalition”) challenges the Department’s rule, contending that it should be set aside under the Administrative Procedure Act because, inter alia, the Department erroneously interpreted NDAA-08 to require refunds by manufacturers to DoD and to require the statute’s obligations to apply beginning on January 28, 2008. Before the Court are the parties cross-motions for summary judgment. 1
I.
The Court, and the parties, have been here before.
See Coal. for Common Sense in Gov’t Procurement v. United States,
Section 703 of NDAA-08 requires pharmaceuticals obtained through the TRI-CARE retail pharmacy program be subject to Federal Ceiling Prices. It provides in a new
[wjith respect to any prescription filled on or after the date of the enactment of the National Defense Authorization Act for Fiscal Year 2008, the TRICARE retail pharmacy program shall be treated as an element of the Department of Defense for purposes of the procurement of drugs by Federal agencies under section 8126 of title 38 to the extent necessary to ensure that pharmaceuticals paid for by the Department of Defense that are provided by pharmacies under the program to eligible covered beneficiaries under this section are subject to the pricing standards in such section 8126.
And it requires DoD, after consultation with other administering agencies, to “modify the regulations under [
The Defense Department published a notice of proposed formal rulemaking to implement section 703 in July 2008.
See
73 Fed. Reg. 43,394 (July 25, 2008). After receiving comments on the proposed rule, the Department published its final rule on March 17, 2009, to be effective May 26, 2009.
See
74 Fed. Reg. 11,279 (March 17, 2009). The rule requires pharmaceutical manufacturers to honor section 703’s obligation that “TRICARE retail pharmacy network prescriptions are subject to Federal Ceiling Prices.”
Three provisions accomplish this outcome. First, the Defense Department and pharmaceutical manufacturers may enter into voluntary written agreements in which manufacturers agree “to honor the pricing standards required by
Second, if a manufacturer does not agree to meet the Federal Ceiling Prices through such an agreement, but nevertheless provides pharmaceuticals through the retail pharmacy program, DoD may obtain refunds on transactions in excess of the Federal Ceiling Prices through a debt collection action.
See
Finally, the manufacturer may escape the Federal Ceiling Prices altogether by
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voluntarily removing the drug “from coverage in the TRICARE Pharmacy Benefit Program.”
II.
Under
A court must “hold unlawful and set aside agency action, findings, and conclusions” that are “arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law,”
III.
This Court reviews an agency’s regulations according to the familiar two-step framework articulated in
Chevron, U.S.A., Inc. v. Natural Resources Def. Council, Inc.,
When an agency’s construction of a statute is challenged, its “interpretation need not be the best or most natural one by grammatical or other standards.... Rather [it] need be only reasonable to warrant deference.”
Pauley v. BethEnergy Mines, Inc.,
Here, the parties raise two separate interpretive issues regarding
A.
1.
The Court begins with
Chevron
step one, and the question whether
The Department’s interpretation of the statute is less clear. In its litigation papers and at the motion hearing, the Department suggests that the provisions of the final rule resulted from the exercise of its discretion. See, e.g., Def.’s Mem. at 14 (“DoD relied upon its expertise in crafting the provisions of the Final Rule.”); id. at 15 (the regulation “is analyzed under step two of the Chevron framework because Congress has not spoken directly to the precise question at issue”); Def.’s Reply in Supp. of Def.’s Mot. for Summ. J. (“Def.’s Reply”) [Docket Entry 52], at 5 (“The actual text of the Final Rule and its Preamble are more than sufficient to prove that DoD exercised its discretion and that the Final Rule is a product of DoD’s bringing its experience and expertise to bear in light of competing interests at stake.” (quotation omitted)); Summ. J. Hr’g Tr. at 33:18-23 (“The Court: Do you agree with me that a manufacturer refund is not required under the statute? [DoD counsel]: I guess I do agree with that ....”); id. at 33:1-2 (“The agency exercised its discretion here.... ”).
But the Department suggested quite the opposite in the rule’s preamble:
DoD interprets the statute as establishing the fact of an overpayment and the need for a refund. These things are not dependent on the agreement to exist; *54 they exist by operation of law under the statute.
The plain language of
Indeed, the Court can imagine several other regulatory schemes consistent with
2.
Having concluded that the statutory language does not speak to precisely how the Department should implement the statute, the Court ordinarily would move to
Chevron
step two, and ask whether the agency’s interpretation of the statute is reasonable.
See Chevron,
The discretion accorded to agencies under
Chevron
in interpreting a statute “must be exercised through the eyes of one who realizes he possesses it.”
Transitional Hosps.,
Here, the Department has offered two opposing interpretations of
Hence, the Department’s only
relevant
interpretation of
Because the statutory language and structure conclusively demonstrate that DoD’s interpretation as reflected in the preamble is incorrect, the agency’s decision cannot stand and the Court must remand the rule to the Department.
See Prill, 755
F.2d at 948;
see also Thompson,
B.
The Court now returns to
Chevron
step one to examine the second issue before the Court: DoD’s conclusion that
Not so, according to the Coalition. Because the statute “does not mandate any rebate payments by manufacturers ..., the statute plainly does not mandate rebate payments by manufacturers as to particular transactions.” PL’s Mem. at 26. But this contention misapprehends the issue. The question is not whether the statute mandates manufacturer refunds beginning on January 28, 2008. Rather, the precise question is whether the statute’s requirement that TRICARE drug prescriptions are subject to the Federal Ceiling Prices — however implemented by the agency — is active on January 28, 2008, or only once DoD promulgates a rule to implement the statute.
On this latter question, the statutory language is clear: “With respect to
any
prescription filled
on or after the date of the enactment of [NDAA-08],”
pharmaceuticals purchased through the retail pharmacy program are subject to the Fed
*57
eral Ceiling Prices.
The Coalition, however, suggests that the “on or after” language refers only to “the point at which the TRICARE retail pharmacy program ... must be treated ... as an element of DoD that does procure drugs.” Pl.’s Mem. at 37. Under its reading, “[o]nce the TRICARE retail pharmacy program is treated as a procurement program, there are actions ... that are necessary to implement the Federal Ceiling Price standards with respect to specific prescription transactions.” Id. DoD must create “the particular mechanism through which it will apply the standard” and enter “contractual agreements pursuant to the regulation.” Id.
But the Coalition’s suggested interpretation contravenes the plain structure of the statute, which expressly makes all prescriptions filled after the date of enactment of NDAA-08 subject to the Federal Ceiling Prices. The Coalition ignores the fact that the phrase “the TRICARE retail pharmacy program ... be treated as an element of the Department of Defense for purposes of procurement” is not an independent clause. Instead, it is a part of a longer clause defining how DoD may apply the Federal Ceiling Prices to the retail pharmacy program. And the Coalition’s interpretation ignores the fact that the retail pharmacy program’s treatment as an element of the Defense Department is not a free-standing statutory component. Rather, it is a mechanism to ensure that the retail pharmacy program pharmaceutical sales are subject to the Federal Ceiling Prices.
4
See
Nor is the Coalition’s interpretation saved by reference to the Medicaid rebate statute.
See
DoD is correct, then, that
The Coalition is not persuasive on this point. “Retroactive rules ‘alter the
past
legal consequences of past actions.’ ”
Mobile Relay Assocs. v. FCC,
Even if any single party involved in the retail pharmacy program did not expect to face refund liability under a final rule, “a
*59
new rule is not retroactive ‘merely because it ... upsets expectations based on prior law.’ ”
DIRECTV,
IV.
Because DoD improperly interpreted
The agency’s erroneous interpretation of
The second
Allied-Signal
factor— the disruptive effect of vacatur — also weighs in favor of remand without vacatur. Vacating the rule would require the Department to reimburse the refunds pharmaceutical companies have now paid to the Department under various agreements. And if the rule is repromulgated in its current form, the Department would once again have to collect refunds pursuant to
V.
The Court concludes that DoD erroneously interpreted
Notes
. Although the Coalition originally filed this suit to challenge an earlier DoD attempt at implementing
. The rule does not affect the rights or liabilities of any of the other parties that participate in the retail pharmacy program: wholesalers, network pharmacies, private pharmacy benefit managers, and TRICARE beneficiaries. See Pl.'s Mem. in Supp. of PL’s Mot. for Partial Summ. J. ("PL's Mem.'') [Docket Entry 44], at 4 (chart detailing the parties involved in a retail pharmacy program transaction).
. At the motions hearing, the Department attempted to reconcile these disparate explanations, offering that in the preamble the Department simply was "interpreting the statute.” Summ. J. Hr’g Tr. at 32:6-7. The Court is not convinced. The mere fact that the agency "interpreted” the statute is of no moment. An agency must always "interpret” a statute, both where the statute commands a particular result and where the agency implements the statute through the exercise of its discretion. The point here is
how
the agency interpreted
. The Coalition ties its alternative interpretation to the contention that the statute requires "DoD to enter into contractual agreements pursuant to the regulation, the terms of which would govern future prescription transactions. It is this agreement with DoD ... that triggers application of the Federal Ceiling Price standards under [NDAA-08].” PL's Mem. at 37-38. But this conclusion ignores the statutory language — nowhere does the statute require a contractual agreement between DoD and a pharmaceutical manufacturer to implement the Federal Ceiling Prices. Indeed, such a requirement is belied by the conclusion that
. Congress therefore does not have to expressly grant the Department the authority to promulgate a retroactive rule. See PL’s Mem. at 40-41. The statute itself made the Federal Ceiling Prices applicable to retail pharmacy transactions beginning on January 28, 2008. The Department’s rule simply reflects Congress’s express command.
. The Coalition asserts this argument in the context of challenging the rule’s requirement of manufacturer refunds. This specific challenge is mooted by the Court’s conclusion that DoD erroneously interpreted
. Nor can the Coalition assert that the rule is retroactive merely because it "changes the legal landscape.”
Nat’l Mining Ass’n v. Dep’t of Labor, 292
F.3d 849, 859 (D.C.Cir.2002). "[I]f that were all it took to render a rule impermissible under the APA, it would spell the end of informal rulemaking.”
Nat’l Cable & Telecomm. Ass’n,
. To be sure, the D.C. Circuit has suggested that remand without vacatur might be inappropriate where the court does not reach "the bulk” of a party's "potentially meritorious challenges.”
Cement Kiln Recycling v. EPA,