prohibiting network exclusion for pharmacies that refuse to dispense a prescription of the PBM reimbursement that is below the pharmacy's acquisition cost.

Senate Bill 247 modifies regulations for contracts between health carriers, pharmacy benefit managers (PBMs), and pharmacies. It requires PBMs and carriers to provide more transparency regarding drug reimbursement calculations, known as Maximum Allowable Cost (MAC) pricing, and establishes a formal appeal process for pharmacies to dispute these costs. The bill also allows pharmacies to decline to dispense a drug if the reimbursement amount is less than their acquisition cost. Additionally, it mandates that Pharmacy Services Administrative Organizations (PSAOs) provide pharmacies with copies of PBM contracts and prohibits them from requiring pharmacies to purchase drugs from specific entities. These provisions are set to take effect on January 1, 2026.