Appeal procedure: A PBM must provide an appeal procedure, including a right to appeal that is limited to 14 days following initial claim, to allow pharmacies with which the PBM has a contract to challenge MAC price for a specified drug. Resolution of appeals: A PBM must respond to appeal within 14 days after the receipt of the appeal. The PBM must respond appeal as follows: (A) If upheld, the PBM must make the appropriate adjustment in the MAC and permit the challenging pharmacy to reverse and rebill the claim in question; or (B) denied, the PBM must provide the challenging pharmacy or pharmacist the NDC from national/regional wholesalers of a comparable prescription drug that may be purchased at or below the MAC.

Link to Existing Law: Chapter 56 ‐C ‐Title 24 ‐A § 4350

This is a relatively strong/good law.