Bill > S665

This bill aims to regulate the distribution and payment of specialty medications in Massachusetts. The key provisions are: 1. It prohibits health plans, including those offered through the state's health insurance exchange, from requiring specialty pharmacies to dispense medications directly to patients for the patient to transport to their healthcare provider. 2. It allows but does not require plans to cover home infusion pharmacies or infusion sites external to a patient's provider office/clinic. 3. It sets specific requirements for plans when they do require specialty pharmacies to distribute medications directly to provider settings, including advance notice, exception processes, delivery timelines, and quality/safety standards for the specialty pharmacies. 4. It prohibits plans from requiring certain medications, like those needing same-day compounding or controlled substances, to be distributed from specialty pharmacies. 5. It requires plans to offer "site neutral" payment to healthcare providers who administer medications distributed from specialty pharmacies, covering the providers' costs to intake, store, and dispose of the medications. Overall, the bill aims to ensure patient safety and provider flexibility in the distribution of complex specialty medications while also addressing payment issues for providers administering these drugs.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/193/S665