Bill > H1237

This bill prohibits "nonmedical switching" - which refers to a health plan's restrictive changes to its formulary after the current plan year has begun or during the open enrollment period for the upcoming plan year, causing a plan enrollee who is medically stable on their current prescribed drug to switch to a less costly alternate prescription drug. The bill requires health plans to continue coverage of a plan enrollee's previously approved prescription drug if the enrollee is medically stable on the drug, and provides a process for plan enrollees to request a coverage exemption determination if their plan makes restrictive changes to its formulary. The bill is applicable to health benefit plans delivered, issued for delivery, continued, or renewed in Massachusetts on or after January 1, 2022.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/192/H1237