State Tracker Updated June 15, 2026

Wyoming: what the PBM reimbursement law requires

Wyoming requires PBMs to build MAC lists from widely available, appropriately rated drugs, keep MAC pricing transparent, and provide MAC and audit appeals — but it imposes no reimbursement floor.

Status	Partially enacted
Law	Wyo. Stat. §§ 26-52-101 to 26-52-104 (PBM Act, 2016; amended through 2023)
Effective date	2016 (amended through 2023)
Reimbursement basis	No reimbursement floor. To place a drug on a MAC list, the PBM must ensure it is appropriately rated and generally available for purchase by retail pharmacies in the state, and may consider only the price of that drug and therapeutic equivalents in setting MAC. A MAC appeal and audit-appeal protections apply.
Professional dispensing fee	Not specified in statute
Appeal route	Pharmacy has up to 10 business days after dispensing to appeal a MAC amount; the PBM must respond within 10 business days

Wyoming’s PBM Act (Wyo. Stat. ch. 26-52, enacted 2016 and amended through 2023) regulates how MAC lists are built and appealed, not a reimbursement floor. A drug can be placed on a MAC list only if it is appropriately rated and generally available to retail pharmacies in the state, and the PBM considers only the drug and its therapeutic equivalents in setting the price.

Pharmacies have up to 10 business days after dispensing to appeal a MAC amount, with a 10-business-day response window, plus audit-appeal protections. The Act imposes no NADAC or acquisition-cost floor.

Sources

Wyo. Stat. § 26-52-104 — Maximum allowable cost (codified) Primary source
Wyoming Department of Insurance — Pharmacy Benefit Managers Primary source

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