FL S1014

Creates new law regulating pharmacy benefit managers (PBMs) and contracts between PBMs and pharmacies that include maximum allowable cost (MAC) pricing for drugs.

Requires PBMs to update MAC pricing at least every 7 calendar days, notify pharmacies of updates promptly, and adjust pricing to reflect marketplace changes.

Prohibits PBMs from placing drugs on MAC lists unless the drug has at least two or more nationally available generic alternatives that are therapeutically equivalent, cost-competitive, and available from wholesalers.

Requires PBMs to disclose to plan sponsors the methodology for MAC pricing, whether different MAC lists apply to retail versus mail order drugs, and any differences between amounts paid to pharmacies and charged to plan sponsors.

Mandates all PBM-pharmacy contracts include an appeal process for MAC pricing disputes with 90-day appeal window, 7-day investigation period, and requires PBMs to provide reasons for denied appeals and identify alternative drugs available at or below MAC pricing.