Bill > H953

This bill proposes to regulate separate out-of-pocket insurance limits for prescription drugs, including specialty drugs, in Massachusetts. The key provisions are: 1. Any health insurance policy, contract, or certificate issued, delivered, or renewed in Massachusetts that provides prescription drug coverage must establish a separate out-of-pocket limit for prescription drugs, including specialty drugs. 2. The out-of-pocket limit for prescription drugs cannot exceed the minimum annual deductible for a high-deductible health plan under the federal Internal Revenue Code, which is set annually. 3. The "out-of-pocket limit" includes any cost-sharing expenditures related to prescription drug coverage, as defined by the federal Patient Protection and Affordable Care Act. 4. The bill applies to all health insurance policies, contracts, and certificates delivered, issued, or renewed on or after January 1, 2015. The purpose of this bill is to provide additional financial protections for patients by capping the out-of-pocket costs they may face for their prescription drugs, including more expensive specialty medications.

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https://malegislature.gov/Bills/191/H953