IL HB3572

Establishes regulations for pharmacy benefits managers' maximum allowable cost (MAC) lists used to set reimbursement rates to pharmacies, requiring drugs on MAC lists be therapeutically equivalent, available from national/regional wholesalers in Illinois, and not obsolete.

Requires pharmacy benefits managers to provide pharmacies access to MAC lists, update them within 7 calendar days of a 10% or greater pharmacy acquisition cost increase or 60% or more of wholesalers changing prices, and notify pharmacies of updates.

Mandates reasonable administrative appeal procedures allowing pharmacies to challenge MAC costs and reimbursements, with 7 business days to file appeals and 7 business days for PBM response, including options to adjust costs or provide wholesaler information.

Prohibits pharmacy benefits managers from reimbursing in-state pharmacies at lower rates than their own affiliated pharmacies for identical services and allows pharmacies to decline services if reimbursement falls below their acquisition cost.

Classifies violations of these MAC list and pharmacy benefits manager requirements as deceptive trade practices under Illinois law.