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MAC Appeal Deadlines by State — and Where to Confirm Yours

MarkupRxPublished June 23, 2026

TL;DR

The window to appeal a below-cost MAC reimbursement is short — often somewhere between roughly a week and a month — but it is not the same everywhere, and in many states it isn’t set by statute at all; it’s set by your PBM contract. Roughly three dozen states have MAC-pricing-specific laws, while all 50 regulate PBMs in some way. Pick your state below to see what’s commonly reported for your filing window, who oversees PBMs there, and — most importantly — exactly where to confirm the current rule for your situation.

How to use this

For your state, you’ll see four things: the commonly-reported filing window (unverified), who regulates PBMs there, whether a win must be applied to similarly situated pharmacies, and a short “how to confirm” path. Treat the window as a prompt to go check — not as the deadline itself. The fastest authoritative answers come from your state’s insurance department PBM page (or Board of Pharmacy / Attorney General where noted), your PBM’s provider manual, and your PSAO.

One caveat that applies to every state below: roughly three dozen states have MAC-pricing-specific laws while all 50 regulate PBMs in some way, so the count is a range, not a hard number — and even where a state sets a window, your PBM contract may set a shorter one. The values here are commonly reported and unverified; they are a place to start looking, never something to rely on.

Pick your state

This tool is a starting point, not legal advice. Filing windows and PBM rules vary by state, by PBM contract, and by claim type, and they change. Every value here is commonly reported and unverified — always confirm the current rule with the authority named for your state before you rely on it.

Jump to your state:

Alabama

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Alabama Department of Insurance
Similarly situated: Not confirmed
NADAC floor: Reported: yes
Where to confirm: Alabama Department of Insurance; your PBM provider manual.

Alaska

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~10 business days (reported)
PBM response: ~10 business days (reported)
PBM oversight: Alaska Division of Insurance
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Alaska Division of Insurance; your PBM provider manual.

Arizona

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Arizona Department of Insurance & Financial Institutions
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Arizona Dept of Insurance & Financial Institutions; your PBM provider manual.

Arkansas

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~30 business days (reported)
PBM response: ~30 business days (reported)
PBM oversight: Arkansas Insurance Department
Similarly situated: Reported: yes
NADAC floor: Reported: yes
Where to confirm: Arkansas Insurance Department PBM page; your PBM provider manual; your PSAO.

California

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: California Department of Insurance / DMHC
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: California Dept of Insurance or DMHC; your PBM provider manual.

Colorado

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~21 business days (reported)
PBM response: ~21 business days (reported)
PBM oversight: Colorado Division of Insurance
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Colorado Division of Insurance; your PBM provider manual.

Connecticut

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Connecticut. Connecticut regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Connecticut sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Connecticut: (1) the Connecticut Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Delaware

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~10 business days (reported)
PBM response: ~10 business days (reported)
PBM oversight: Delaware Department of Insurance
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Delaware Department of Insurance; your PBM provider manual.

District of Columbia

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for District of Columbia. District of Columbia regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If District of Columbia sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for District of Columbia: (1) the District of Columbia Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Florida

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Limited PBM-pricing law reported
Filing window: Not confirmed (prompt-pay / anti-steering focus)
PBM response: Not confirmed
PBM oversight: Florida Department of Financial Services (Medicaid via AHCA)
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Florida Department of Financial Services; your PBM provider manual.

Georgia

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Georgia Office of Insurance
Similarly situated: Reported: yes
NADAC floor: Reported: yes
Where to confirm: Georgia Office of Insurance; your PBM provider manual.

Hawaii

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Hawaii. Hawaii regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Hawaii sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Hawaii: (1) the Hawaii Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Idaho

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Idaho. Idaho regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Idaho sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Idaho: (1) the Idaho Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Illinois

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Illinois. Illinois regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Illinois sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Illinois: (1) the Illinois Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Indiana

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Indiana Department of Insurance
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Indiana Department of Insurance; your PBM provider manual.

Iowa

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported (MAC law partly enjoined — litigation)
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Iowa Insurance Division
Similarly situated: Not confirmed
NADAC floor: Reported (subject to litigation)
Where to confirm: Iowa Insurance Division; your PBM provider manual. Note: subject to litigation.

Kansas

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~10 business days (reported)
PBM response: ~10 business days (reported)
PBM oversight: Kansas Insurance Department
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Kansas Insurance Department; your PBM provider manual.

Kentucky

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Kentucky Department of Insurance
Similarly situated: Not confirmed
NADAC floor: Reported: yes
Where to confirm: Kentucky Department of Insurance; your PBM provider manual.

Louisiana

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~15 business days (reported)
PBM response: ~15 business days (reported)
PBM oversight: Louisiana Department of Insurance
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Louisiana Department of Insurance; your PBM provider manual.

Maine

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~14 days (reported)
PBM response: ~14 days (reported)
PBM oversight: Maine Bureau of Insurance
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Maine Bureau of Insurance; your PBM provider manual.

Maryland

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Maryland Insurance Administration
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Maryland Insurance Administration; your PBM provider manual.

Massachusetts

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Massachusetts. Massachusetts regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Massachusetts sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Massachusetts: (1) the Massachusetts Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Michigan

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Michigan. Michigan regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Michigan sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Michigan: (1) the Michigan Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Minnesota

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Minnesota. Minnesota regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Minnesota sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Minnesota: (1) the Minnesota Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Mississippi

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~30 days or less (reported)
PBM response: ~30 days (reported)
PBM oversight: Mississippi Board of Pharmacy
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Mississippi Board of Pharmacy PBM page; your PBM provider manual.

Missouri

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~14 calendar days (reported)
PBM response: ~14 calendar days (reported)
PBM oversight: Missouri Department of Commerce & Insurance
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Missouri Dept of Commerce & Insurance; your PBM provider manual.

Montana

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Montana Commissioner of Securities & Insurance
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Montana Commissioner of Securities & Insurance; your PBM provider manual.

Nebraska

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Nebraska Department of Insurance
Similarly situated: Not confirmed
NADAC floor: Reported: yes (managed Medicaid)
Where to confirm: Nebraska Department of Insurance; your PBM provider manual.

Nevada

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Nevada. Nevada regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Nevada sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Nevada: (1) the Nevada Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

New Hampshire

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for New Hampshire. New Hampshire regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If New Hampshire sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for New Hampshire: (1) the New Hampshire Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

New Jersey

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: New Jersey Department of Banking & Insurance
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: New Jersey Dept of Banking & Insurance; your PBM provider manual.

New Mexico

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for New Mexico. New Mexico regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If New Mexico sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for New Mexico: (1) the New Mexico Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

New York

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: New York Department of Financial Services
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: New York Department of Financial Services; your PBM provider manual.

North Carolina

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Limited PBM-pricing law reported
Filing window: Not confirmed (no below-cost appeal confirmed)
PBM response: Not confirmed
PBM oversight: North Carolina Department of Insurance
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: North Carolina Department of Insurance; your PBM provider manual.

North Dakota

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: North Dakota Insurance Department
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: North Dakota Insurance Department; your PBM provider manual.

Ohio

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~21 business days (reported)
PBM response: ~21 business days (reported)
PBM oversight: Ohio Department of Insurance
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Ohio Department of Insurance; your PBM provider manual.

Oklahoma

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~10 business days (reported)
PBM response: ~10 business days (reported)
PBM oversight: Oklahoma Attorney General
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Oklahoma Attorney General (PBM enforcement); your PBM provider manual.

Oregon

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: Oregon Division of Financial Regulation
Similarly situated: Not confirmed
NADAC floor: Not confirmed
Where to confirm: Oregon Division of Financial Regulation; your PBM provider manual.

Pennsylvania

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Pennsylvania. Pennsylvania regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Pennsylvania sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Pennsylvania: (1) the Pennsylvania Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Rhode Island

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Rhode Island. Rhode Island regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Rhode Island sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Rhode Island: (1) the Rhode Island Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

South Carolina

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for South Carolina. South Carolina regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If South Carolina sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for South Carolina: (1) the South Carolina Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

South Dakota

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for South Dakota. South Dakota regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If South Dakota sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for South Dakota: (1) the South Dakota Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Tennessee

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~7 business days (reported)
PBM response: ~7 business days (reported)
PBM oversight: Tennessee Department of Commerce & Insurance
Similarly situated: Not confirmed
NADAC floor: Reported: yes
Where to confirm: Tennessee Dept of Commerce & Insurance; your PBM provider manual.

Texas

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: reported response by the 15th day
PBM response: reported by the 15th day
PBM oversight: Texas Department of Insurance
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Texas Department of Insurance; your PBM provider manual.

Utah

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Utah. Utah regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Utah sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Utah: (1) the Utah Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Vermont

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Vermont. Vermont regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Vermont sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Vermont: (1) the Vermont Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Virginia

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Virginia. Virginia regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Virginia sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Virginia: (1) the Virginia Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Washington

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: ~30 calendar days (reported)
PBM response: reported to adjust within ~1 day after
PBM oversight: Washington Office of the Insurance Commissioner
Similarly situated: Reported: yes
NADAC floor: Not confirmed
Where to confirm: Washington Office of the Insurance Commissioner; your PBM provider manual.

West Virginia

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

MAC law: Reported to have a MAC-specific law
Filing window: Not confirmed
PBM response: Not confirmed
PBM oversight: West Virginia Offices of the Insurance Commissioner
Similarly situated: Not confirmed
NADAC floor: Reported: yes
Where to confirm: West Virginia Offices of the Insurance Commissioner; your PBM provider manual.

Wisconsin

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Wisconsin. Wisconsin regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Wisconsin sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Wisconsin: (1) the Wisconsin Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Wyoming

Unverified — confirm

Every value below is commonly reported and unverified. Confirm the current rule with the authority named before you rely on it — windows vary by PBM contract, by claim type, and by state, and they change.

We don't yet have a verified MAC-appeal filing window for Wyoming. Wyoming regulates PBMs in some form, but whether it provides a specific below-cost MAC appeal process — and any deadline — is not confirmed here. If Wyoming sets no statutory window, the deadline is likely defined by your PBM contract.

How to confirm for Wyoming: (1) the Wyoming Department of Insurance PBM page; (2) your PBM's provider/payer manual; (3) your PSAO; (4) the NCPA PBM Complaints resources. These control — confirm before relying on any deadline.

Why the deadline matters more than almost anything else

A late appeal is dead on arrival no matter how strong the underlying claim — see the documentation that wins an appeal. Because windows can be as short as a few business days from the original claim, the practical move is to calendar the deadline the moment you spot a below-NADAC fill, not when you get around to it.

For the end-to-end mechanics — identifying the underwater NDC, assembling the package, submitting, and escalating — see the full appeal process. To see which generic NDCs go underwater most often in your state, see your underwater NDCs in the public explorer (no login).

Related reading

How to File a MAC Appeal — and Win NADAC vs. PBM Reimbursement: Why Pharmacies Lose Money on Generic Fills What is a PSAO — and Does Your Independent Pharmacy Need One?What Documentation Wins a MAC Appeal (and Why So Many Get Denied)How Drug Shortages Quietly Put Your Generics Underwater Does Your PSAO Already Handle Your MAC Appeals? How to Tell What You’re Actually Getting Explore drug pricing data →

Frequently Asked Questions

It varies. Commonly-reported windows range from roughly seven business days to about thirty days, but many states leave it to the PBM contract rather than statute. Confirm your specific window with your state’s insurance department and your PBM’s provider manual — don’t assume.

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