An Act relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth

This bill (HD 1305) requires pharmacy benefit managers (PBMs) operating in Massachusetts to follow specific rules when setting reimbursement rates for pharmacies. It mandates that PBMs provide transparent access to their "maximum allowable cost" drug lists, update them within 7 days if pharmacy acquisition costs rise by 10% or more, and establish a clear 7-business-day appeal process for pharmacies challenging low reimbursements. Pharmacies can refuse services if paid below their actual drug purchase cost ("pharmacy acquisition cost"), and PBMs must reimburse pharmacies equally to what they pay their own affiliated pharmacies for the same services. The law applies to all PBMs, including those working with MassHealth, and violations are classified as deceptive trade practices under existing law.