MA H1325

Amends Chapter 176D by adding Section 3C to regulate maximum allowable cost (MAC) lists used by pharmacy benefits managers (PBMs) to reimburse pharmacies for generic drugs and medical devices

Requires drugs on MAC lists to be FDA "A" or "AB" rated with at least two therapeutically equivalent options or one generic available from wholesalers; drugs no longer meeting requirements must be removed within 3 business days

Mandates MAC reimbursements be equal to or greater than pharmacy acquisition costs, with lists updated every 3 business days and payment calculations updated within 2 business days

Establishes a 7-business-day appeals process for pharmacies to contest MAC pricing, with successful appeals requiring adjustments for all similar network pharmacies within 3 business days

Prohibits PBMs from penalizing pharmacists for disclosing cost-share information to patients or recommending more affordable alternative medications