Bill > H1104

This bill aims to ensure access to generic medications by regulating the practices of pharmacy benefits managers (PBMs) and covered entities. The key provisions include: 1. PBMs and covered entities must use a maximum allowable cost (MAC) list that meets certain criteria, such as listing drugs with "A" or "AB" ratings from the FDA's Orange Book, and having at least two therapeutically equivalent, multiple-source drugs or one generic drug available. 2. PBMs and covered entities must update MAC lists at least every 3 business days and make the lists accessible to contracted pharmacies. 3. Pharmacies can contest the listed MAC for a drug or medical product, and the PBM or covered entity must resolve the appeal within 7 business days, providing an alternative drug if the appeal is denied. 4. The Insurance Commissioner is responsible for enforcing the act and can examine or audit the PBM's records to ensure compliance. 5. The bill also prohibits contracts from restricting pharmacies or pharmacists from disclosing certain healthcare information to patients, including the patient's cost-share and the availability of more affordable alternative drugs.