Massachusetts House Bill H1131

Massachusetts 2023-2024 Regular Session

• Introduced: 2/16/23
• Refer: 2/16/23

Caption

Relating to patient cost, benefit and coverage information, choice, and price transparency

Impact

The bill modifies Chapter 94C of the General Laws to mandate the disclosure of significant details about prescription drugs, including cost-sharing information, eligibility for coverage, and available alternatives. This not only empowers patients but also holds health insurance providers accountable for transparency in their pricing and coverage practices. The expectation is that increased access to this information will lead to better healthcare decisions by patients and ultimately could foster competition among providers to offer better prices.

Summary

House Bill H1131 aims to enhance transparency in the healthcare sector, focusing on providing patients with comprehensive cost, benefit, and coverage information related to prescription drugs. This legislation requires health plans and pharmacy benefit managers to furnish real-time data regarding the costs and covered benefits of prescription medications upon request from patients or their representatives. It emphasizes that this information must be accurate and current, allowing patients to make informed decisions about their healthcare options and associated costs.

Contention

Notably, there are concerns surrounding the implications of this bill. Some stakeholders argue that while increased transparency is beneficial, there may be challenges related to the accurate and timely provision of information by health plans. Specifically, there is apprehension regarding how these entities will adapt to the new requirements and whether they will face pressure that could complicate their operational capabilities. Additionally, the balancing act between protecting sensitive patient data and ensuring transparency is a point of discussion among legislators and advocacy groups.