AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO PHARMACY BENEFITS MANAGERS.

Summary

The bill adds detailed procedures that pharmacy benefits managers (PBMs) must follow when auditing pharmacies, including advance notice, limits on frequency, and cost responsibilities. It also creates a clear, time‑bound process for pharmacies to appeal reimbursement decisions, especially when payments fall below a defined “net amount.” These changes aim to make audits more transparent and give pharmacies a fair chance to contest low reimbursements.

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