Bill > H931

This bill aims to promote high-value and high-quality healthcare. It makes several key changes: 1. It expands the membership of the Health Policy Commission to include more representatives from the pharmaceutical industry and pharmacy benefit managers, and requires them to provide testimony on factors underlying prescription drug costs and price increases. 2. It directs the Commission to develop an evidence-based outreach and education program to support the therapeutic and cost-effective utilization of prescription drugs by healthcare providers. 3. It requires pharmaceutical companies to provide early notice to the Commission about new pipeline drugs, generic drugs, and biosimilar products that may have a significant impact on healthcare expenditures. 4. It adds definitions for "pharmaceutical manufacturing company" and "pharmacy benefit manager" to the law, and requires them to submit certain data to the Center for Health Information and Analysis. 5. It prohibits out-of-network providers from balance billing patients for "unavoidable" out-of-network services, and establishes a process for mediating disputes between providers and insurers over reimbursement rates for such services. 6. It requires insurers to cover telehealth services to the same extent as in-person services, and prohibits them from requiring additional documentation or limiting the settings where telehealth can be provided.

Business and Industry

https://malegislature.gov/Bills/191/H931