Bill > H1326

This bill amends Chapter 118E Section 9B to enhance transparency and fairness in prescription medication access and pricing. Specifically, the bill requires MassHealth Managed Care Organizations and Accountable Care Organizations to reimburse pharmacies at consistent rates outlined in the MassHealth Pharmacy Provider Manual. The Insurance Commissioner is empowered to enforce the act, including the ability to examine and audit pharmacy benefits managers' (PBMs) books and records, while maintaining the confidentiality of proprietary information. The legislation also protects pharmacists and pharmacies by prohibiting PBMs from penalizing them for providing patients with comprehensive healthcare information, including treatment alternatives, healthcare service authorization processes, and financial details. Crucially, the bill allows pharmacists to inform patients about their prescription drug cost-sharing and potential more affordable alternative medications without facing retribution from PBMs. This bill aims to increase patient awareness, promote cost-effective healthcare choices, and ensure more transparent communication between healthcare providers, patients, and insurance organizations.

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https://malegislature.gov/Bills/194/H1326