State Tracker Updated June 15, 2026

Hawaii: what the PBM reimbursement law requires

Hawaii requires PBMs to keep MAC lists current (updated at least every 7 days) and to give pharmacies a MAC appeal, but it does not guarantee a reimbursement floor tied to NADAC or acquisition cost.

Status	Partially enacted
Law	Haw. Rev. Stat. § 328-106
Effective date	In force (current codified version)
Reimbursement basis	No reimbursement floor. PBMs must review and update the MAC of each listed drug at least once every seven days using the most recent data, applying the update the same day, and must maintain a MAC appeals process.
Professional dispensing fee	Not specified in statute
Appeal route	Pharmacy has at least 14 business days after payment to file; PBM makes a final determination within 14 business days; if upheld, the PBM must identify an equivalent drug available at or below the appealed MAC, and if not upheld it adjusts the MAC within one day with reverse-and-rebill

Hawaii’s PBM statute (HRS § 328-106) governs the mechanics of maximum-allowable-cost pricing rather than setting a reimbursement floor. PBMs must review and adjust the MAC of each listed drug at least once every seven days using current data and apply the updated list the same day.

Pharmacies can appeal a MAC: at least 14 business days to file and a 14-business-day decision window, with the MAC adjusted (and reverse-and-rebill allowed) if the appeal succeeds. The statute does not require reimbursement at or above NADAC or acquisition cost.

Sources

Haw. Rev. Stat. § 328-106 (codified) Primary source
Hawaii DCCA — Pharmacy Benefit Manager regulation Primary source

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