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MA H3787

MA H3787
Relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth


summary

Introduced
05/20/2021
In Committee
05/20/2021
Crossed Over
Passed
Dead
12/31/2022

Introduced Session

192nd General Court

Bill Summary

Relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth. Health Care Financing.

AI Summary

This bill aims to regulate the reimbursement practices of Pharmacy Benefit Managers (PBMs) in Massachusetts. It requires PBMs to adhere to specific guidelines when establishing Maximum Allowable Cost (MAC) lists, which are used to determine the reimbursement rates for pharmacies. The bill mandates that PBMs provide pharmacies with access to their MAC lists, update them promptly, and establish an administrative appeal process for pharmacies to challenge reimbursement rates. Additionally, the bill prohibits PBMs from reimbursing their affiliated pharmacies at lower rates than other pharmacies for the same services. This legislation aims to ensure fairness and transparency in the PBM-pharmacy reimbursement process, ultimately benefiting pharmacies and patients in the Commonwealth.

Committee Categories

Health and Social Services

Sponsors (3)

Last Action

Accompanied S771 (on 11/17/2021)

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