The bill requires a pharmacy benefit manager (PBM) to include the basis for determining maximum allowable cost pricing in each contract between a pharmacy benefit manager and a pharmacy, update the pricing information at least every 7 days. The bill also requires a PBM to maintain a procedure to eliminate products from the list of drugs subject to maximum allowable cost pricing.
In order for a prescription drug to be placed on a maximum allowable cost list, the bill requires a PBM to ensure that the drug meets specific requirements.
The bill requires each contract between a PBM and a pharmacy to include a process to appeal, investigate, and resolve disputes regarding maximum allowable cost pricing.