An Act relative to prescription drug pricing

This bill requires pharmacy benefits managers (PBMs) to obtain a license from the Massachusetts insurance commissioner before providing drug pricing services. It establishes rules for how PBMs set reimbursement rates for prescription drugs ("Maximum Allowable Cost" or MAC), requiring them to update these rates every 7 days and base them on FDA-approved drug lists. PBMs must also provide transparent pricing information to hospitals and insurers about the difference between what they pay pharmacies and what they bill covered entities. Pharmacies can appeal low reimbursement rates under a standardized process, and PBMs must respond to appeals within 10 business days. The law directly affects PBMs, hospitals, insurers, and employers offering health coverage in Massachusetts.