Bill > H491

This bill aims to increase transparency in the healthcare sector by requiring drug manufacturers and pharmacy benefit managers (PBMs) to report certain information to the state. Specifically, the bill requires drug manufacturers to file information with the Department of Public Health when they experience a 15% or more increase in the wholesale acquisition cost of a prescription drug sold or marketed in the Commonwealth. This includes the current wholesale acquisition cost, the amount and history of recent price increases, as well as information about the manufacturer's research and development costs and revenues. The bill also requires PBMs under contract with health insurance plans ("covered entities") to report to the covered entities and the Commissioner of Insurance certain information about the PBM's pharmacy benefits management activities, such as generic dispensing rates, the aggregate amount of rebates and discounts negotiated, and the difference between what the covered entity paid the PBM and what the PBM paid retail pharmacies. Additionally, the bill requires health insurance plans to publicly post their drug formularies, including details about utilization management requirements, cost-sharing amounts, and how drugs are treated in relation to deductibles. The goal of these provisions is to provide greater transparency around drug pricing and PBM practices in order to help control healthcare costs for consumers.

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https://malegislature.gov/Bills/190/H491