A PBM shall update pricing information on the MAC list at least every 10 calendar days; maintain a procedure to eliminate products from the list of drugs subject to such pricing, or modify MAC rates when such drugs do not meet the standards and requirements of this section in order to remain consistent with pricing changes in the marketplace. All contracts between a PBM, a contracted pharmacy or, alternatively, a PBM and a pharmacy’s contracting representative or agent, such as a pharmacy services administrative organization (PSAO), shall include a process to appeal, investigate, and resolve disputes regarding MAC pricing.

Link to Existing Law: RI ST § 27-20.1-15.1

Given the appeal can only be made to the PBM, there is opportunity to advocate for a stronger regulatory scheme and oversight of PBM. The law could also be strengthened by requiring PBMs automatically apply the changed price to all similarly situated pharmacies and to apply it on a prospective basis. Interestingly, the law requires that there be an “adequate supply” of product available from regional or national wholesalers and is not temporarily unavailable.