The District of Columbia regulates PBM conduct rather than pharmacy reimbursement. Its PBM statute (the AccessRx Act, D.C. Code §§ 48-832.01–.02) imposes a fiduciary duty on the PBM toward the covered entity, requires conflict-of-interest disclosure, and requires full pass-through of manufacturer payments and rebates.
There is no MAC pricing or appeal requirement and no reimbursement floor in the commercial PBM statute; District Medicaid sets its own pharmacy reimbursement under separate rules. The District is therefore shown here as regulating PBMs without a floor.