Pharmacists for Fair Reimbursement What your state's PBM laws actually mean for community pharmacies
State Tracker Updated June 15, 2026

North Carolina: what the PBM reimbursement law requires

North Carolina's SCRIPT Act requires PBMs to reimburse independent pharmacies — and any pharmacy in a pharmacy desert — at no less than the drug's acquisition cost, plus affiliate parity and rebate pass-through.

Status Enacted
Law SCRIPT Act — Session Law 2025-69 (SB 479), G.S. § 58-56A-4
Effective date October 1, 2025 (for contracts entered, renewed, or amended on or after that date)
Reimbursement basis Reimbursement rates for an independent pharmacy, or any pharmacy in a pharmacy desert, must be at a minimum the acquisition cost for the covered drug, device, or service. PBMs also may not pay a pharmacy less than they pay a PBM affiliate for the same service, and rebate pass-through and audit protections apply.
Professional dispensing fee Floor is acquisition cost; the Act sets no separate commercial dispensing-fee amount
Appeal route MAC pricing and appeals under G.S. § 58-56A-5

North Carolina is a reimbursement-floor state for the pharmacies this tracker is about. Under the SCRIPT Act (Session Law 2025-69, G.S. § 58-56A-4), effective October 1, 2025 for new, renewed, or amended contracts, a PBM must reimburse an independent pharmacy — or any pharmacy located in a pharmacy desert — at no less than the acquisition cost for the covered drug, device, or service.

The Act also bars a PBM from paying a pharmacy less than it pays its own affiliate for the same service, requires rebate pass-through, and strengthens audit and transparency protections. The acquisition-cost floor is scoped to independent and pharmacy-desert pharmacies rather than every pharmacy, which is stated plainly in the implementing agency letter linked above.

Sources

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