SC H4791

Requires all pharmacies permitted in South Carolina to cooperate with federal and state drug acquisition cost surveys, including the National Average Drug Acquisition Cost (NADAC) survey

Prohibits pharmacy benefits managers (PBMs) from reimbursing pharmacies below NADAC plus the current South Carolina Medicaid professional dispensing fee for prescription drugs and pharmacy services

Requires PBMs to use Wholesale Acquisition Cost (WAC) plus the Medicaid dispensing fee as the minimum reimbursement when NADAC pricing is unavailable

Establishes a complaint process through the Department of Insurance for pharmacies reimbursed below minimum requirements, with the department required to make determinations within 30 days of receiving a PBM response

Requires PBMs whose complaints are upheld to pay twice the underpayment amount within 30 days and apply corrections to all similarly situated pharmacies