HD 2276 establishes new duties for pharmacy benefit managers (PBMs) to act transparently and in the best interest of patients, health insurance plans, and pharmacies. It requires PBMs to disclose conflicts of interest, explain fees clearly, and prevent "spread pricing" (charging more than the drug cost plus dispensing fee). The law prioritizes patient interests over other parties and mandates transparency in formulary design, billing, and pricing. This directly affects all PBMs working with health insurance plans in the state, including their fees, pricing practices, and interactions with patients and pharmacies.
By Representative Murray of Milford, a petition (accompanied by bill, House, No. 785) of Brian W. Murray relative to 340B contract pharmacies. Elder Affairs.
This bill establishes new duties for pharmacy benefit managers (PBMs), the companies that manage prescription drug benefits for health insurance plans. It requires PBMs to act with care, transparency, and fairness toward patients (enrollees), health plans, and pharmacies, prioritizing patient interests when conflicts arise. Key provisions include mandating clear disclosure of fees and conflicts of interest, prohibiting excessive "spread pricing" (where PBMs retain fees beyond actual drug costs), and requiring transparent processes for formulary decisions and appeals. Violations may result in monetary penalties or license suspension by the state commissioner. The bill directly affects PBMs, health insurers, pharmacies, and patients covered by health benefit plans.
HD 1369 prohibits licensed health insurers (subject to specific Massachusetts insurance laws) from requiring annual re-authorizations for prescription drugs treating chronic conditions. It directly affects patients with conditions like diabetes, heart disease, Alzheimer's, cancer, stroke, or respiratory disease, as well as their insurers. The bill's key provision bans insurers from demanding yearly approval for these specific medications once a physician, physician's assistant, or nurse practitioner has prescribed them. This changes the current process by eliminating an administrative hurdle for ongoing treatment of chronic illnesses.
H 4496 requires health insurance plans covering prescriptions to allow partial medication fills at a pro-rated daily cost when a doctor or pharmacist determines it benefits the patient and the patient agrees. It prohibits insurers from denying coverage for partial fills used to synchronize multiple prescriptions (e.g., aligning refill dates for several medications). The bill also mandates full payment for dispensing fees on partial fills and blocks insurers from using pro-rated dispensing fees. This directly affects patients needing medication synchronization, pharmacists, prescribers, and health insurance plans in Massachusetts.
This bill mandates that most health insurance plans in Massachusetts cover acupuncture for specific conditions, including pain management, PTSD, substance abuse treatment, and nausea. It requires insurers to provide these benefits without differentiating reimbursement rates between licensed acupuncturists and medical doctors. The bill also creates a commission to study how to better integrate acupuncture into mainstream healthcare delivery, focusing on cost reduction, access, and quality. These changes directly affect insurance companies, healthcare providers, and Massachusetts residents seeking acupuncture services.
Senate, September 25, 2025 -- Text of the Senate Bill establishing the Massachusetts data privacy act (being the text of Senate document 2608, printed as amended)
This bill requires Massachusetts correctional facilities to provide free contraceptive services - including reversible methods, emergency contraception, and nonprescription options - to all incarcerated individuals capable of pregnancy upon request, with no unnecessary obstacles. It mandates family planning counseling 60-180 days before release, ensures continuity of prescribed birth control methods, and requires facilities to post clear information about reproductive health rights. For pregnant individuals, the bill guarantees they can determine their own abortion eligibility under state law, with informed consent required and prison staff barred from making such decisions. The Department of Correction must implement these changes within one year of passage.
This bill amends Massachusetts medical parole procedures to clarify eligibility and streamline the process. It redefines "permanent incapacitation" as irreversible physical/cognitive impairment and "terminal illness" as a condition likely causing death within 18 months. The bill requires correctional facilities to assess prisoners aged 55+ annually for cognitive decline, mandates medical documentation and violence risk assessments for parole petitions, and prioritizes community placement in a prisoner's home unless public safety risks exist. It directly affects incarcerated individuals with serious medical conditions who may qualify for release under these updated criteria.
This bill creates a state grant program administered by the Executive Office of Health and Human Services to fund community-based organizations that provide non-law-enforcement responses to certain 911 calls and non-emergency situations. It directly affects local governments, community organizations, and residents by supporting alternatives to police involvement for mental health crises, violence prevention, and social service referrals. Key provisions include requiring competitive grants for partnerships between local governments and community groups, mandating evaluation of outcomes like reduced police calls and improved service access, and prohibiting grant funds from going to law enforcement agencies. The program also requires community stakeholder boards and detailed application requirements focused on service planning, community engagement, and data collection.
HD 828 requires correctional institutions housing women to provide a written brochure with clear, culturally competent information on women’s health, contraception, and sexually transmitted infections. For female prisoners of child-bearing age, it mandates that at least four months before release, they must be offered contraception counseling, a gynecological exam (including a Pap test), and a choice of contraceptive methods, with a 12-month prescription and referrals for follow-up care upon release. The bill also requires the creation of a monthly health education curriculum covering topics like women’s health, domestic violence, contraception, and infant care, developed with the Department of Public Health and offered regularly to all eligible incarcerated people. These provisions directly affect women in state correctional facilities, aiming to improve health access before and after release.
This bill creates a state-funded pilot program to help people with Long COVID access better healthcare in Massachusetts. It requires the health department to develop a "patient navigation" service that connects patients with medical specialists, social support (like transportation or housing help), and resources to address daily challenges. The program must reduce barriers to care, study related conditions (such as ME/CFS or heart disease), and include input from Long COVID patients through a consumer advisory board. The department must report on the pilot's progress within one year, including participation numbers and recommendations for expansion.
