MA H1157

Requires pharmacy benefit managers (PBMs) to pay pharmacies dispensing fees at least equal to Massachusetts Medicaid rates and prohibits retroactive rate reductions using "Generic Effective Rate" or "Brand Effective Rate" pricing

Prohibits PBMs from engaging in "pharmacy steering" that channels prescriptions to PBM-owned pharmacies, and requires equal or greater payment to non-affiliated pharmacies compared to PBM-affiliated pharmacies

Mandates that any Massachusetts-licensed pharmacy be allowed to dispense specialty medications if willing to meet service requirements, with requirements applied uniformly across all pharmacies

Requires PBMs to update maximum allowable cost lists every 3 business days, provide pharmacies a 7-day appeals process for drug cost disputes, and prohibits PBMs from charging community pharmacies credentialing fees

Grants the Insurance Commissioner authority to enforce the act through examinations and audits of PBM records, with examination data exempt from public records disclosure