NC S451

Requires pharmacy benefits managers to place prescription drugs on maximum allowable cost price (MAC) lists only if the drugs are available for purchase from national or regional wholesalers in North Carolina, are not obsolete, and meet FDA ratings or comparable standards.

Mandates that pharmacy benefits managers review MAC prices at least once every seven business days and adjust or remove prices to remain consistent with national marketplace changes.

Requires pharmacy benefits managers to provide contracted pharmacies with current price information electronically, in print, or by telephone within one business day of any MAC price removal or modification.

Establishes penalties of $100 to $1,000 per day per prescription drug for pharmacy benefits managers that fail to timely perform required reviews, adjustments, or removals of MAC prices.

Designates failure to comply with MAC price review and adjustment requirements as an unfair or deceptive insurance practice enforceable under state insurance law.