Bill > S1163

This bill aims to increase transparency and access in healthcare by implementing the following key provisions: 1. Manufacturer Transparency: Requires drug manufacturers that have experienced a 15% or more increase in the wholesale acquisition cost of a prescription drug over a 12-month period to report detailed information about the drug's pricing, research and development costs, and rebates or discounts provided to the state's Medicaid program. 2. Pharmacy Benefit Manager Transparency: Requires pharmacy benefit managers (PBMs) under contract with health plans to report information about generic dispensing rates, rebates and discounts negotiated, and the difference between what the health plan paid the PBM and what the PBM paid pharmacies. 3. Formulary Disclosure: Requires health insurance plans to post their formularies (the list of covered drugs) online, update them within 24 hours of changes, and disclose detailed information about cost-sharing, utilization management requirements, and how medications are included in or excluded from deductibles. The goal of these provisions is to provide consumers, policymakers, and other stakeholders with more information about the costs and pricing dynamics in the pharmaceutical and health insurance markets.

Health and Social Services

https://malegislature.gov/Bills/190/S1163