Arkansas recently enacted a new law favoring independent pharmacies in filling prescriptions through insurance companies and Pharmacy Benefit Managers (PBMs). The law – which became effective on July 22, 2015 – requires transparency of Maximum Allowable Costs (MAC) and requires PBMs to make its MAC lists available for regular publication. With respect to pharmacies, the law requires an administrative appeal procedure for Arkansas pharmacies to challenge MAC pricing for any specific drug and offers protection for pharmacies, allowing them to challenge MAC pricing where it is set below the pharmacy’s acquisition cost. A violation of this new law constitutes deceptive and unconscionable trade practices in Arkansas and creates both civil and criminal liability to a PBM for violations. Pharmacies that take action against PBM for violation of this regulation can seek damages and attorney’s fees.
The PBM industry has filed suit against the state of Arkansas to prevent implementation and enforcement of the law.
Frier Levitt has experienced attorneys able to assist your pharmacy in pursuing the MAC pricing appeals and litigation or arbitration against PBM’s in violation of this new law. If you are experiencing issues regarding MAC price, contact Frier Levitt today.
