PBMs must provide a process for each participating pharmacy provider to readily access the MAC list specific to that provider. The law requires any contract between a health insurance carrier and its intermediary, to establish a MAC, and require the intermediary or carrier to update, not less frequently than once every seven days, unless there has been no change to the MAC of any drug on the list since the last update.

Link to Existing Law: VA Code Ann. § 38.2-3407.15:3

The law requires PBMs to update the MAC prices more frequently than every 7 days when there has been a change in the acquisition costs. However, the law could be improved in that it expressly denies the Commission any jurisdiction to adjudicate individual controversies arising out of this section. In addition, given the appeal can only be made to the PBM, there is opportunity to advocate for a stronger regulatory scheme and oversight of PBM.