Bill > H4891

This bill: Expands the definition of "payer" to include any entity, other than an individual, that pays providers for health care services, including self-insured plans. It also defines "pharmaceutical manufacturing company" and "pharmacy benefit manager." Establishes an office of pharmaceutical policy and analysis within the Health Policy Commission to analyze pharmaceutical spending data, produce reports on access, affordability and spending, assist with identifying supplemental rebates, and advise the legislature and state agencies on pharmaceutical drug policy. Requires pharmaceutical manufacturing companies and pharmacy benefit managers to pay an assessment to the Health Policy Commission to help fund its expenses. Mandates that the Health Policy Commission and Center for Health Information and Analysis collect and analyze data from pharmaceutical manufacturing companies, pharmacy benefit managers, and other entities to improve transparency around drug pricing and pharmaceutical spending. Caps copayments for certain generic and brand-name drugs used to treat chronic conditions like diabetes and asthma, and requires health plans to cover these drugs with little to no cost-sharing. Regulates pharmacy benefit managers, including licensing requirements, prohibitions on spread pricing and certain fees, and requirements around pharmacy audits and maximum allowable cost lists. Overall, the bill aims to improve transparency and affordability in the pharmaceutical market and mitigate rising drug costs for consumers and the healthcare system.

House Committee on Ways and Means (House)

https://malegislature.gov/Bills/193/H4891