MA S831

Requires pharmacy benefit manager (PBM) contracts with pharmacies to include dispensing fees no less than Massachusetts Medicaid rates and prohibits retroactive rate reductions like "Generic Effective Rate" or "Brand Effective Rate" discounts

Prohibits PBMs from engaging in "pharmacy steering" (directing prescriptions to pharmacies they own) and requires non-affiliated pharmacies receive equal or greater payment than PBM-owned pharmacies

Mandates that any Massachusetts-licensed pharmacy be allowed to dispense specialty medications if willing to meet service requirements, preventing exclusion of community pharmacies from specialty drug networks

Establishes requirements for maximum allowable cost (MAC) lists including updates every 3 business days, transparency to pharmacies, and a 7-business-day appeal process for pharmacies to contest drug pricing

Grants the Insurance Commissioner enforcement authority to examine PBM records and requires PBMs to submit annual reports on denied pharmacy appeals; prohibits PBMs from charging community pharmacies credentialing fees