MA S827

Regulates pharmacy benefits managers (PBMs) by establishing requirements for maximum allowable cost (MAC) lists, including that drugs must be FDA "A" or "AB" rated and available from at least two sources before being placed on such lists

Requires PBMs to reimburse pharmacies at or above the pharmacy's acquisition cost (with National Average Drug Acquisition Cost as a safe harbor) and prohibits setting lower MAC prices for non-affiliated pharmacies than for PBM-owned pharmacies

Mandates PBMs update MAC lists every 3 business days, provide lists to contracted pharmacies, and establish a 7-business-day appeals process for pharmacies to contest drug pricing with retroactive adjustments for valid appeals

Prohibits retroactive discounts (including Generic Effective Rate and Brand Effective Rate) and requires all discounts to be applied at the time claims are paid

Protects pharmacists from being penalized for disclosing cost-share information to patients or recommending more affordable alternative medications, and requires MassHealth managed care organizations to reimburse pharmacies at standard MassHealth rates