Bill > H934

This bill enacts the Pharmacy Benefit Manager Compensation Reform Act of 2022 in Massachusetts. The key provisions are: 1. Pharmacy benefit managers (PBMs) can only derive income from pharmacy benefit management fees, not from spread pricing or other contingent fees. The amount of these fees must be specified in the contract with the health insurance carrier or plan. 2. PBMs, carriers, and health plans are prohibited from engaging in or facilitating spread pricing, which is charging more than the ingredient cost plus dispensing fee. 3. The state insurance commissioner and contracted carriers/plans can audit PBMs annually to review reimbursement rates, any differences between affiliated and unaffiliated pharmacies, and aggregate rebate amounts received by the PBM. 4. The commissioner can impose penalties, including license suspension or revocation, if a PBM is found to be in violation of the law. The intent of the bill is to increase transparency and oversight of PBM practices to protect consumers and ensure PBMs are acting in the best interests of health plans and enrollees.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/193/H934