Massachusetts Senate Bill S601

Massachusetts 2023-2024 Regular Session

• Introduced: 2/16/23
• Refer: 2/16/23
• Refer: 3/7/24

Caption

Prohibiting self-dealing by pharmacy benefit managers and pharmacies under common ownership

Impact

If passed, S601 would specifically amend Chapter 6D of the General Laws by introducing measures that restrict health benefit plans or PBMs from penalizing or providing financial incentives to insured individuals to use specific pharmacies in which they have vested interests. The implications of this bill would potentially reshape the landscape of pharmacy benefit management, pushing for a more equitable framework that discourages any practices that could financially disadvantage patients. This alteration of state law could lead to changes in how pharmacies contract with PBMs and how patients access their medications.

Summary

Bill S601, presented by Cynthia Stone Creem, aims to prohibit self-dealing practices by pharmacy benefit managers (PBMs) and pharmacies with common ownership. The bill seeks to amend existing laws by defining pharmacy benefit managers and establishing clearer parameters regarding their roles and responsibilities in managing prescription drug benefits. The intention behind this legislation is to enhance transparency and fairness within the pharmacy benefit management sector, especially concerning the financial transactions and incentives that influence patients' choices of pharmacies. By limiting the potential for self-serving financial arrangements, legislators hope to mitigate the conflicts of interest that could affect patient care.

Contention

The deliberations surrounding S601 highlight significant contention among stakeholders. Proponents of the bill argue that allowing PBMs to exert control over which pharmacies patients use can lead to improper financial coercion, ultimately harming consumers financially and health-wise. Critics, however, may express concern about the potential regulation overreaches into business operations, suggesting that it could reduce flexibility and choice for consumers in managing their prescriptions. These differing perspectives underscore a broader debate about regulation in health services and balancing consumer protections against business interests.