MN HF1872

Pharmacy benefit managers must provide contracted pharmacies with current lists of sources used to determine maximum allowable cost (MAC) pricing, updated at least every seven business days.

Pharmacies have the right to review current MAC prices in electronic, print, or telephonic format within one business day at no cost.

Drugs placed on MAC lists must be generally available for purchase from national or regional wholesalers in Minnesota and not be obsolete.

Contracts must include a dispute resolution process allowing pharmacies to appeal MAC pricing decisions within 15 business days, with investigations and resolutions required within seven business days.

Pharmacy benefit managers must provide denial reasons and identify specific national drug codes for alternative drugs purchasable at or below the MAC price, and apply upheld adjustments to all similarly situated network pharmacies within one business day.