Bill > S756

This bill aims to establish new requirements and a review process for step therapy protocols used by MassHealth and health insurance carriers in Massachusetts. Key provisions include: 1) Requiring MassHealth and health insurance carriers to grant expedited exceptions to step therapy protocols in certain circumstances, such as when the prescribed drug is contraindicated, ineffective, or not in the best interest of the enrollee/insured. 2) Mandating a clear and accessible process for enrollees/insureds to request step therapy exceptions, and requiring carriers to respond within 72 hours (or 24 hours in urgent cases). 3) Creating a commission on step therapy protocols to study and assess the implementation of these reforms, including their impact on costs, quality, and health disparities. 4) Specifying that the new step therapy exception requirements will apply to MassHealth starting January 1, 2022, and to health benefit plans renewed after that date.

Health and Social Services

https://malegislature.gov/Bills/192/S756