Massachusetts H1330 regulates pharmacy benefit managers' reimbursements to pharmacies, ensuring fair compensation.
Massachusetts H1330 establishes guidelines for pharmacy benefit managers' reimbursements to pharmacies, ensuring fair compensation. It mandates that drugs on a maximum allowable cost list must be therapeutically and pharmaceutically equivalent, available for purchase from wholesalers, and not obsolete. Pharmacies can challenge reimbursements if they are below the pharmacy acquisition cost. The pharmacy benefits manager must respond to such challenges within seven business days, provide necessary information, and allow pharmacies to reverse and rebill claims.
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