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Topic MAC

MAC list governance

Published findings, original references and room for an evidence-backed challenge.

What the rubric looks for

A single MAC list applies to both what the plan pays and what pharmacies are paid, it is disclosed, updated on a schedule, and pharmacies have an appeals path with defined timelines.

Why it matters

Two MAC lists (one for the plan, one for pharmacies) is the classic spread pricing mechanism.

MAC · Weight 5/100 · Introduced in rubric v1

Reference: Section 3.5

Only the selected record is loaded. Findings below are not a cross-contract tally or community activity.

Published evidence

Travis County · Envision Pharmaceutical Services, LLC

Published Commons finding

Not addressedFinding rubric version not recorded

No evidence quotation was recorded for this finding.

Recorded reference: No page reference recorded

Published rationale. All five models reached this verdict. Maximum allowable cost appears on pages 10 and 11 only as the label for the current OptumRx generic pricing, while the proposed Envision generic rates are stated as discounts off average wholesale price. There is no statement that one list governs both what the county pays and what pharmacies are paid, no update schedule and no pharmacy appeal path. The executed agreement is not part of this agenda backup and nothing in the 18 pages is redacted, so the subject is absent rather than unreadable.

“Not addressed” is this published review’s conclusion about the produced text, not proof that a provision is absent from every version or withheld document.

Inspect historical council readings (5 recorded for this criterion)

These are separately attributed readings of this record, not independent community contributions. Versions can differ; no new consensus has been calculated.

Claude Opus 5

Not addressedRubric v2 · Historical council reading

No evidence quotation was recorded for this finding.

Recorded reference: No page reference recorded

Published rationale. Maximum allowable cost appears in the tables on pages 10 and 11 only as the label for the current pricing arrangement with OptumRx, while the proposed Envision generic rates are stated as discounts off average wholesale price. There is no statement that a single list governs both what the county pays and what pharmacies are paid, no disclosure requirement, no update schedule and no pharmacy appeals path with timelines. Whether any list governance exists would have to be read in the executed agreement, which is not part of the packet.

“Not addressed” is this published review’s conclusion about the produced text, not proof that a provision is absent from every version or withheld document.

Gemini 3.1 Pro

Not addressedRubric v2 · Historical council reading

No evidence quotation was recorded for this finding.

Recorded reference: No page reference recorded

Published rationale. Although MAC pricing is mentioned in the summary tables, the lack of the base agreement means MAC list governance rules and appeals paths are completely missing.

“Not addressed” is this published review’s conclusion about the produced text, not proof that a provision is absent from every version or withheld document.

GPT 5.6 Sol

Not addressedRubric v2 · Historical council reading

No evidence quotation was recorded for this finding.

Recorded reference: No page reference recorded

Published rationale. Page 11 mentions MAC pricing only in the current mail-order comparison, while Envision's proposed generic prices are stated as AWP discounts. No Envision clause requires one disclosed MAC list, scheduled updates, or a pharmacy appeal process with deadlines. The executed agreement is absent.

“Not addressed” is this published review’s conclusion about the produced text, not proof that a provision is absent from every version or withheld document.

Grok 4.6

Not addressedRubric v2 · Historical council reading

No evidence quotation was recorded for this finding.

Recorded reference: No page reference recorded

Published rationale. Page 10 shows current generic pricing as MAC and proposed generic pricing as AWP-74.5%, and page 11 shows mail generic moving from MAC Pricing to AWP-79.00%. That is a change in the pricing index, not MAC list governance. There is no single list for plan and pharmacy, no disclosure schedule, and no pharmacy appeals path in this backup.

“Not addressed” is this published review’s conclusion about the produced text, not proof that a provision is absent from every version or withheld document.

Kimi K3

Not addressedRubric v2 · Historical council reading

No evidence quotation was recorded for this finding.

Recorded reference: No page reference recorded

Published rationale. The letters MAC appear on pages 10 and 11 only in the current UHC column, where generic pricing is listed as MAC or MAC Pricing, while the proposed Envision pricing is stated as AWP discounts (AWP-74.5% retail, AWP-79.00% mail). There is no mention of a MAC list for the new contract, no disclosure or update schedule, and no pharmacy appeals process.

“Not addressed” is this published review’s conclusion about the produced text, not proof that a provision is absent from every version or withheld document.

Document manifest and citation limits

Quotations and rationales are reproduced from published findings, not newly verified here. Named exhibits, amendments and ambiguous references must be checked in the document itself.

Community participation

Have contrary evidence, a missing exhibit or a question about the interpretation? Use the existing community composer to prepare a labelled finding. Publishing a community post is separate from a Commons review and does not change the contract score.

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PBM Commons · by BetterBuy RxEvidence is public. Interpretation is open to review.

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