Bill > H1305

This bill addresses medication synchronization and cost-sharing for health insurance policies in Massachusetts. Specifically, the bill requires health insurance plans that provide prescription drug coverage to permit pro-rated daily cost-sharing for partial prescription supplies when a prescriber or pharmacist determines it is in the patient's best interest and the patient agrees to the partial supply for medication synchronization purposes. The legislation prevents insurance companies from denying coverage for partial prescription fills intended to help patients align multiple medication refill dates. Furthermore, the bill mandates that pharmacies be allowed to override denial codes that typically prevent early prescription refills when the goal is medication synchronization. Importantly, while insurance plans must pro-rate the medication cost for patients, they must pay dispensing fees in full for each prescription, ensuring pharmacies are fully compensated for their services. This approach aims to improve patient medication management, potentially enhancing treatment adherence by making it easier for patients to coordinate their various prescription refill schedules while protecting both patient and pharmacy financial interests.

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https://malegislature.gov/Bills/194/H1305