MA H1326

Regulates pharmacy benefits managers (PBMs) by requiring drugs on maximum allowable cost lists to be FDA-rated "A" or "AB" and available from at least two therapeutically equivalent sources or one generic manufacturer

Mandates PBMs reimburse pharmacies at or above their acquisition cost, with reimbursement rates for non-affiliated pharmacies equal to or greater than rates for PBM-affiliated pharmacies

Establishes a 7-business-day appeals process for pharmacies to contest drug pricing, with PBMs required to retroactively adjust and reprocess claims if appeals are validated

Prohibits retroactive discounts (including Generic Effective Rate and Brand Effective Rate) and requires PBMs to update maximum allowable cost lists every 3 business days

Requires MassHealth Managed Care and Accountable Care Organizations to reimburse pharmacies at standard MassHealth rates, and protects pharmacists from penalties for disclosing cost-share information or more affordable alternatives to patients