MA H1167

Establishes legal duties for pharmacy benefit managers (PBMs) to act with care, skill, prudence, and good faith toward enrollees, health benefit plans, and healthcare providers

Requires PBMs to provide transparency about pricing practices, including disclosure of "spread pricing" (amounts retained by PBMs above drug costs and dispensing fees) and all conflicts of interest

Creates a hierarchy of duties where obligations to enrollees take priority over duties to providers, which in turn take priority over duties to health benefit plans

Authorizes the commissioner to impose monetary penalties, suspend or revoke PBM licenses for violations, and establishes an administrative appeals process

Directs the commissioner to adopt regulations defining the specific scope of duties owed to each party, including requirements for transparent formulary design and utilization management