All states › District of Columbia
District of Columbia PBM MAC rights
Status No usable MAC appeal right
What the law says
No MAC law and no PBM licensure statute. D.C. Code §§ 48-832.01–.03 impose a fiduciary duty running to the plan sponsor, not to pharmacies. Violation = Consumer Protection Procedures Act, fine ≤$10,000
How we determined that
Full subchapter read; site-restricted index searches for "maximum allowable cost" and "pharmacy benefits manager"
This is worth knowing precisely
Several widely used sources still describe rights in states that repealed them, or quote bills that never passed. If you have been told you have an appeal right here, check the statute before you rely on it. What we found.
Your contract may still give you more than the statute does, and the request letter costs you nothing to send.
Sources
The full chapter text was read for this jurisdiction to confirm the absence of a MAC provision.
Think this is wrong? Tell us and we will check it. A repeal we missed, or a provision we read past, is exactly what we want to hear about.
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