H.B. 2644 Summary

• Establishes new requirements for pharmacy benefit managers using maximum allowable cost (MAC) reimbursement, placing oversight under the Department of Commerce and Consumer Affairs instead of the Department of Health.

• Requires PBMs to provide contracting pharmacies with comprehensive MAC lists at least quarterly and upon request, review and adjust MAC prices at least weekly, and establish a clear appeal process with 14 business day decision timelines.

• Limits MAC list inclusion to drugs rated "A" or "B" in the FDA Orange Book, available from national or regional wholesalers, and not obsolete.

• Allows pharmacies to appeal MAC prices if they are below wholesale acquisition costs or if drugs fail to meet eligibility requirements, with PBMs required to provide reasons for upheld appeals and equivalent drug alternatives.

• Increases penalties for PBM violations to up to $10,000 per violation and removes the prohibition preventing pharmacies from disclosing MAC list information to third parties; effective January 1, 2020.