Healthcare (Prescription Drugs)

passed · Massachusetts · House Jan 20, 2026

H 1359: An Act relative to capping the price of epinephrine

This bill (HD 2903) requires health insurance plans to cover epinephrine autoinjectors for anaphylaxis treatment with specific cost limits. It mandates that coverage for one brand-name or generic epinephrine autoinjector (sold as a two-pack) cannot include deductibles or co-insurance, and co-payments must not exceed $60. The law directly affects individuals with severe allergies requiring emergency epinephrine treatment, ensuring predictable out-of-pocket costs for this critical medication. It amends multiple sections of health insurance law to explicitly include anaphylaxis as a covered condition and set the $60 co-pay cap.

Topics ✓ HealthcareSupports HealthcareCapping epinephrine prices directly improves patient access to affordable emergency care, addressing a critical healthcare affordability issue for allergy patients.95% confidence

Sub-Topics Prescription Drugs

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introduced · Massachusetts · House

HD 1157: An Act relative to pharmacy benefit managers

This bill regulates pharmacy benefit managers (PBMs) to improve transparency and fairness in drug pricing. It requires PBMs to: (1) pay pharmacies promptly for "clean claims" (complete, error-free claims) without retroactively reducing payments; (2) cap patient cost-sharing (copays, deductibles) at the pharmacy’s contracted price; and (3) maintain transparent, frequently updated maximum allowable cost lists for generic drugs, allowing pharmacies to challenge unfair pricing. The bill directly affects PBMs, community pharmacies (excluding mail-order from network calculations), and patients who pay for prescriptions. Key provisions aim to prevent unexpected payment cuts and ensure fair reimbursement based on actual drug costs.

Topics ✓ HealthcareSupports HealthcareRegulates PBMs to cap patient costs and ensure transparent pricing, improving access and fairness in drug coverage.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · Senate Jun 16, 2025

S 858: Resolve relative to pharmacy deserts

By Ms. Edwards, a petition (accompanied by resolve, Senate, No. 858) of Lydia Edwards that provisions to assess the supply, distribution and capacity of pharmacy and pharmacological services. Health Care Financing.

Topics ✓ HealthcareSupports HealthcareBill assesses pharmacy supply/distribution to address 'pharmacy deserts,' directly improving patient access to medications and services.85% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · House Sep 18, 2025

H 1092: An Act to ensure affordable prescription medications through accountability standards

By Representative Barber of Somerville, a petition (accompanied by bill, House, No. 1092) of Christine P. Barber and others relative to prescription medications. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill targets affordable prescription medications via accountability standards, directly advancing patient access to essential healthcare services.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · House Sep 18, 2025

H 1274: An Act prohibiting PBMs from discriminating against hospitals and patients participating in the 340B drug discount program

HD 1119 prohibits pharmacy benefit managers (PBMs) from discriminating against hospitals and patients participating in the federal 340B drug discount program. The bill specifically bans PBMs from reimbursing 340B hospitals at lower rates than non-340B hospitals, charging extra fees for 340B participation, restricting network access based on 340B status, or requiring special identification for 340B drugs (except for Medicaid claims). It also prevents PBMs from steering patients away from 340B providers or imposing higher costs like extra copays for drugs obtained through these hospitals. This state-level bill directly affects 340B-covered hospitals (including community health centers and safety-net providers) and their patients by ensuring equitable access to discounted medications.

Topics ✓ HealthcareSupports HealthcareProhibits PBMs from discriminating against 340B program participants, protecting hospital and patient access to discounted drugs, a key healthcare access measure.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · House Mar 12, 2026

H 1205: An Act establishing a commission to study the promotion of preferred pharmacy networks

HD 2249 establishes a commission to study how health insurers use "preferred pharmacy networks" to steer patients toward lower-cost pharmacies where insurers negotiate better drug prices. The commission, composed of legislative leaders, health officials, and policy experts, will analyze the feasibility and cost-benefit of implementing such networks and estimate potential prescription drug savings. It must submit a report with recommendations and draft legislation to relevant committees within 12 months of the bill's passage. This bill does not change current law but creates a formal process to evaluate a specific cost-saving approach used by insurers. The direct effect is on insurers, pharmacies, and the state's health policy decision-makers.

Topics ✓ HealthcareSupports HealthcareBill establishes commission to study insurer negotiations for lower drug prices, aiming to reduce costs and improve access - directly supporting healthcare affordability.85% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · House Mar 12, 2026

H 4181: An Act ensuring pharmacy access

By Representative Garry of Dracut, a petition (subject to Joint Rule 12) of Colleen M. Garry relative to the rights of pharmacists to participate as preferred health care providers. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill ensures pharmacists can serve as preferred healthcare providers, directly improving patient access to pharmacy services and expanding healthcare provider options.95% confidence

Sub-Topics Prescription Drugs

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introduced · Massachusetts · House

HD 1139: An Act 340B Contract Pharmacy Protection Act

This bill protects 340B contract pharmacies by prohibiting drug manufacturers or distributors from restricting access to discounted 340B drugs or demanding unnecessary data sharing as a condition for sale. It directly affects 340B entities (like community health centers and hospitals) that contract with pharmacies to provide discounted medications to eligible patients. The law bans manufacturers from denying, restricting, or prohibiting 340B drug delivery to authorized pharmacy locations unless federal law prohibits it, and prevents requiring extra claims or utilization data beyond federal requirements. Violations are treated as consumer protection law breaches under Massachusetts law, with each restricted drug package counted as a separate violation.

Topics ✓ HealthcareSupports HealthcareProtects 340B contract pharmacies' access to discounted drugs, ensuring community health centers provide affordable medications to eligible patients.95% confidence ✓ TechnologySupports TechnologyBill prohibits drug manufacturers from demanding unnecessary data sharing, directly protecting patient data privacy as a core technology policy concern.90% confidence

Sub-Topics Prescription Drugs

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in committee · Massachusetts · House Jun 17, 2026

H 4346: An Act to ensure access to prescription medications

H 4346 requires pharmacy benefits managers (PBMs) and insurers to follow specific rules for setting maximum allowable costs (MACs) for prescription drugs. Drugs must have available therapeutic equivalents to be listed on MACs, and PBMs must remove them if they no longer meet criteria within 3 business days. The bill mandates transparency by requiring PBMs to share MAC sources, costs, and lists with pharmacies, and creates an appeal process for pharmacies to challenge low MACs, with retroactive payment adjustments if appeals succeed. It also prohibits retroactive discounts and requires MassHealth to reimburse pharmacies at the rate specified in the state’s pharmacy provider manual.

Topics ✓ HealthcareSupports HealthcareMandates transparency and appeal processes for drug pricing to prevent access barriers, directly improving patient access to medications through PBM/insurer regulations.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · Senate Apr 30, 2026

S 687: An Act ensuring access to fair and reasonable pharmacy networks

This bill (SD 761) requires pharmacy benefit managers (PBMs) to maintain fair and accessible pharmacy networks for patients, directly affecting PBMs, health insurers, and community pharmacies. It prohibits "steering" (directing prescriptions to owned/affiliated pharmacies) and mandates that PBMs provide networks with convenient access to physical pharmacies near patients' homes, excluding mail-order options from adequacy calculations. Violating these rules triggers a 10% surcharge on the PBM's prior year's pharmacy reimbursements, payable to the state division. The law aims to prevent anti-competitive practices that limit patient choice and access to local pharmacies.

Topics ✓ HealthcareSupports HealthcareEnsures access to fair pharmacy networks, improving patient access to medications and protecting consumer choice in healthcare services.95% confidence

Sub-Topics Prescription Drugs

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