Drug pricing list; procedural requirements.

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(a) A pharmacy benefits manager shall

(1) make available to each network pharmacy at the beginning of the term of the network pharmacy's contract, and upon renewal of the contract, the methodology and sources used to determine the drug pricing list;

(2) provide a telephone number at which a network pharmacy may contact an employee of a pharmacy benefits manager to discuss the pharmacy's appeal;

(3) provide a process for a network pharmacy to have ready access to the list specific to that pharmacy;

(4) review and update applicable list information at least once every seven business days to reflect modification of list pricing;

(5) update list prices within one business day after a significant price update or modification provided by the pharmacy benefits manager's national drug database provider; and

(6) ensure that dispensing fees are not included in the calculation of the list pricing.

(b) When establishing a list, the pharmacy benefits manager shall use

(1) the most up-to-date pricing data to calculate reimbursement to a network pharmacy for drugs subject to list prices;

(2) multi-source generic drugs that are sold or marketed in the state during the list period.


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