Bill > H1016

This bill enacts a new chapter in Massachusetts law, Chapter 175N, which establishes duties and obligations for pharmacy benefit managers (PBMs). Key provisions include: 1) Defining PBMs as entities that provide pharmacy benefit management services, such as negotiating drug prices, processing claims, and performing other administrative functions related to prescription drug benefits. 2) Requiring PBMs to owe a "pharmacy benefit manager duty" of care, skill, prudence, diligence, fairness, transparency, and professionalism to enrollees, health benefit plans, and providers. This includes duties of care and good faith and fair dealing. 3) Mandating the Commissioner of Insurance to adopt regulations defining the scope of these duties, including obligations around transparency, conflict of interest disclosure, and acting in the best interests of enrollees. 4) Establishing a savings clause to ensure the state only regulates PBMs, carriers, and health benefit plans to the extent permissible under applicable law. 5) Authorizing the Commissioner to impose penalties, including license suspension or revocation, for violations of the chapter or related regulations. The overall purpose is to ensure PBMs perform their duties with transparency and accountability, prioritizing the interests of enrollees, health plans, and providers.

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https://malegislature.gov/Bills/193/H1016