MA H4488

Requires pharmacy benefit managers (PBMs) to update maximum allowable cost lists within 7 calendar days after a 10% or greater increase in pharmacy acquisition costs from 60% or more of wholesalers

Establishes an administrative appeal process for pharmacies to challenge maximum allowable costs, with PBMs required to respond within 7 business days and provide dedicated phone/email contacts for appeals

Prohibits PBMs from reimbursing independent pharmacies less than they reimburse their own affiliated pharmacies for the same services, calculated on a per-unit basis

Allows pharmacies to decline to provide services if reimbursement under a maximum allowable cost list would fall below their acquisition cost for the drug

Applies to PBMs contracted with MassHealth and the Group Insurance Commission, with violations constituting unfair trade practices under Chapter 93A