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HOUSE DOCKET, NO. 111 FILED ON: 1/6/2025
HOUSE . . . . . . . . . . . . . . . No. 1240
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
David Henry Argosky LeBoeuf and Lindsay N. Sabadosa
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to insulin access.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:David Henry Argosky LeBoeuf17th Worcester1/6/2025Lindsay N. Sabadosa1st Hampshire2/11/2025 1 of 5
HOUSE DOCKET, NO. 111 FILED ON: 1/6/2025
HOUSE . . . . . . . . . . . . . . . No. 1240
By Representatives LeBoeuf of Worcester and Sabadosa of Northampton, a petition
(accompanied by bill, House, No. 1240) of David Henry Argosky LeBoeuf and Lindsay N.
Sabadosa relative to insulin access. Financial Services.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 4034 OF 2021-2022.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act relative to insulin access.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 17G chapter 32A of the General Laws, as appearing in the 2018
2Official Edition, is hereby amended by adding the following paragraph:-
3 The commission shall cap the total amount that an individual is required to pay for
4insulin at an amount not to exceed $100 per a 30-day supply of insulin, regardless of the amount
5or type of insulin needed to fill the individual’s prescription.
6 SECTION 2. Chapter 111N of the General Laws is hereby amended by adding the
7following section:-
8 Section 9. (a) As used in this section, the following words shall, unless the context clearly
9requires otherwise, have the following meanings:- 2 of 5
10 “Individuals who urgently need insulin”, individuals who have less than a 7-day supply
11of insulin and are likely to ration insulin without assistance.
12 “Insulin patient assistance program”, assistance in the form of insulin free of charge for a
13specified duration provided by a manufacturer to an eligible individual, including, but not limited
14to: (i) directly to an eligible individual’s licensed practitioner for dispensing or (ii) to an eligible
15individual through a single-use card that can be used at a pharmacy when accompanied by a
16prescription.
17 (b) Every pharmaceutical or medical device manufacturing company, as defined in
18section 1, engaged in the production and distribution of insulin with a Medicaid drug rebate
19agreement pursuant to 42 USC 1396r-8 shall:
20 (1) Ensure that there exists an option as part of the pharmaceutical or medical device
21manufacturing company’s insulin patient assistance program offerings for individuals who
22urgently need insulin and are at risk of rationing to obtain an annual, one-time 30-day supply of
23insulin at no-cost; provided, that the individual: (i) has a prescription for insulin and (ii) provides
24written certification of financial need on a form to be provided by the department.
25 (2) Establish procedures to ensure that participation in the pharmaceutical or medical
26device manufacturing company’s insulin patient assistance program is available to individuals
27who satisfy manufacturer-defined eligibility criteria consistent with this paragraph. The
28pharmaceutical or medical device manufacturing company shall, at minimum:
29 (i) Make available on its website or a website specific to the insulin patient assistance
30program an application form for the pharmaceutical or medical device manufacturing company’s
31insulin patient assistance program; 3 of 5
32 (ii) Within 14 days of receipt of a completed application, issue a written determination to
33the applicant informing them of their eligibility or that more information is needed to determine
34eligibility;
35 (iii) Upon a determination that an applicant is eligible for the insulin patient assistance
36program, the pharmaceutical or medical device manufacturing company shall enroll the applicant
37in its insulin patient assistance program for 1 year, unless the applicant acquires government
38sponsored health insurance at any time during the year the applicant is enrolled in the program;
39and
40 (3) An individual shall be eligible for a pharmaceutical or medical device manufacturing
41company’s insulin patient assistance program if:
42 (i) they are a United States citizen or legal resident;
43 (ii) they have a household income that is equal to or less than 400 per cent of the federal
44poverty guidelines;
45 (iii) they do not have private prescription drug coverage, including a health maintenance
46organization, also known as a HMO, or a preferred provider organization, also known as a PPO;
47and
48 (i) they are not eligible to receive prescription drug benefits through a federally funded
49program or through the Department of Veteran’s Affairs; provided, however, that an individual
50who is enrolled in Medicare Part D may be eligible for a pharmaceutical or medical device
51manufacturing company’s insulin patient assistance program if they meet all other eligibility 4 of 5
52requirements and agree to any program terms and conditions set by the pharmaceutical or
53medical device manufacturing company.
54 (c) A pharmaceutical or medical device manufacturing company may establish a program
55to provide individuals who urgently need insulin through a single-use voucher that is redeemable
56at any retail pharmacy with a prescription.
57 (d) A pharmaceutical or medical device manufacturing company that fails to comply with
58this section shall be punished by a fine of $100,000 per month of noncompliance.
59 SECTION 3. Section 10C of chapter 118E of the General Laws, as appearing in the 2018
60Official Edition, is hereby amended by adding the following paragraph:-
61 The division shall cap the total amount that an individual is required to pay for insulin at
62an amount not to exceed $100 per a 30-day supply of insulin, regardless of the amount or type of
63insulin needed to fill the individual’s prescription.
64 SECTION 4. Section 47N of chapter 175 of the General Laws, as so appearing, is hereby
65amended by adding the following paragraph:-
66 An insurer that provides coverage for insulin pursuant to this section shall cap the total
67amount that a policyholder is required to pay for insulin at an amount not to exceed $100 per a
6830-day supply of insulin, regardless of the amount or type of insulin needed to fill the
69policyholder’s prescription.
70 SECTION 5. Section 8P of chapter 176A of the General Laws, as so appearing, is hereby
71amended by adding the following paragraph:- 5 of 5
72 A contract that provides benefits to individual subscribers or members for insulin
73pursuant to this section shall cap the total amount that an individual subscriber or member is
74required to pay for insulin at an amount not to exceed $100 per a 30-day supply of insulin,
75regardless of the amount or type of insulin needed to fill the individual subscriber or member’s
76prescription.
77 SECTION 6. Section 4S of chapter 176B of the General Laws is hereby amended by
78adding the following paragraph:-
79 A subscription certificate that provides benefits to individual subscribers or members for
80insulin pursuant to this section shall cap the total amount that an individual subscriber or member
81is required to pay for insulin at an amount not to exceed $100 per a 30-day supply of insulin,
82regardless of the amount or type of insulin needed to fill the individual subscriber or member’s
83prescription.
84 SECTION 7. Section 4H of chapter 176G of the General Laws is hereby amended by
85adding the following paragraph:-
86 A contract that provides coverage for insulin pursuant to this section shall cap the total
87amount that an individual is required to pay for insulin at an amount not to exceed $100 per a 30-
88day supply of insulin, regardless of the amount or type of insulin needed to fill the individual’s
89prescription.