Massachusetts House Bill H4411

Massachusetts 2023-2024 Regular Session

• Introduced: 2/20/24
• Refer: 2/20/24

Caption

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

Impact

If enacted, H4411 would amend Chapter 94C of the General Laws of Massachusetts, specifically introducing a set of obligations for health plans and pharmacy benefit managers regarding the disclosure of cost, benefit, and coverage data. This change has the potential to significantly impact state laws governing patient rights and healthcare provider interactions by reinforcing the need for transparency and accountability from insurance providers. Moreover, it addresses issues around interoperability in data sharing to ensure health information is efficiently communicated between providers and patients.

Summary

House Bill 4411, presented in the Massachusetts General Court, aims to improve transparency in healthcare by mandating that health plans and pharmacy benefit managers provide patients with timely access to crucial information regarding drug costs and coverage. This bill intends to empower patients by ensuring they can gain insight into the cost-sharing arrangements for their medications and any potential alternatives that may be more affordable. The legislation would also require the data to be provided in real-time and in formats recognized across industry standards to facilitate easier accessibility.

Contention

While many advocates have lauded H4411 for promoting patient rights and informed decision-making in healthcare, some opponents express concern over the practicality of its implementation. There are fears that stringent requirements could overwhelm small healthcare providers while creating burdensome administrative tasks for business and healthcare practices without necessarily leading to better patient outcomes. Additionally, the bill's provisions may spark debate over the balance between transparency and commercial interests in the health services market, especially concerning proprietary information from pharmacy benefit managers.