Maine sets a reimbursement floor in the structure of the payment itself. Under 24-A M.R.S. § 4350, the amount a carrier or its PBM pays a pharmacy for dispensing a drug must be the ingredient cost plus a dispensing fee, less the patient’s cost-sharing — and the ingredient cost may not exceed the maximum allowable cost or the average wholesale price.
On top of that floor, the statute requires MAC-list transparency, with lists updated at least every 7 business days, and an appeal that must be filed within 14 days of the initial claim and resolved by the PBM within 14 days.