A PBM may not place a drug on a list unless are is at least two therapeutically equivalent multiple source drugs, or at least one generic drug available from only one manufacturer, generally available for purchase by network pharmacies from national or regional wholesalers. PBMs shall make available the sources utilized to determine the MAC pricing. MAC lists shall be updated every seven business days. PBMs must establish a MAC appeals process, and a network pharmacy may appeal a MAC price if the reimbursement for the drug is less than the net amount that the network pharmacy paid to the supplier of the drug. An appeal must be completed within thirty calendar days of the pharmacy making the claim for which an appeal has been requested. If the appeal is denied, the reason for the denial and the NDC of a drug that may be purchased by similarly situated pharmacies at a price that is equal to or less than the MAC. If an appeal is upheld, the PBM shall make an adjustment on a date no later than one day after determination.

Link to Existing Law: RCW 19.340.100

This is a fairly standard MAC law. However, given the appeal can only be made to the PBM, there is opportunity to advocate for a stronger regulatory scheme and oversight of PBM. Note: new law to take effect on 1/1/2022