This bill allows pharmacies to refuse to fill prescriptions if the reimbursement from pharmacy benefits managers (PBMs) is less than the pharmacy's acquisition cost. Specifically, it introduces a new section, 402-N:4-b, which permits pharmacists or pharmacies in a network plan to opt-out of providing brand-name drugs, multi-source generic drugs, supplies, or services under these conditions. Additionally, if a pharmacy declines to fill a prescription, they must inform the patient to contact their insurance carrier or PBM for alternative options. The bill also mandates that contracts between pharmacies and pharmacy services administrative organizations (PSAOs) include provisions for transparency regarding contracts with PBMs, ensuring pharmacies receive timely information about reimbursement rates and payment schedules.

Furthermore, the bill stipulates that contracts with PSAOs cannot require pharmacies to purchase drugs or medical devices from specific entities, and it allows pharmacies to file complaints regarding unlawful contractual provisions. It also clarifies that customers can choose to pay the difference between the acquisition cost and the reimbursement amount if they wish to have their prescription filled at that pharmacy. The definition of a pharmacy services administrative organization is also provided, detailing the administrative services they may offer to independent pharmacies. The act is set to take effect on January 1, 2026.