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2 | 2 | | SENATE DOCKET, NO. 761 FILED ON: 1/14/2025 |
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3 | 3 | | SENATE . . . . . . . . . . . . . . No. 687 |
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4 | 4 | | The Commonwealth of Massachusetts |
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5 | 5 | | _________________ |
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6 | 6 | | PRESENTED BY: |
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7 | 7 | | Cynthia Stone Creem |
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8 | 8 | | _________________ |
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9 | 9 | | To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General |
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10 | 10 | | Court assembled: |
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11 | 11 | | The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: |
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12 | 12 | | An Act ensuring access to fair and reasonable pharmacy networks. |
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13 | 13 | | _______________ |
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14 | 14 | | PETITION OF: |
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15 | 15 | | NAME:DISTRICT/ADDRESS :Cynthia Stone CreemNorfolk and Middlesex 1 of 2 |
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16 | 16 | | SENATE DOCKET, NO. 761 FILED ON: 1/14/2025 |
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17 | 17 | | SENATE . . . . . . . . . . . . . . No. 687 |
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18 | 18 | | By Ms. Creem, a petition (accompanied by bill, Senate, No. 687) of Cynthia Stone Creem for |
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19 | 19 | | legislation to ensure access to fair and reasonable pharmacy networks. Financial Services. |
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20 | 20 | | The Commonwealth of Massachusetts |
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21 | 21 | | _______________ |
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22 | 22 | | In the One Hundred and Ninety-Fourth General Court |
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23 | 23 | | (2025-2026) |
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24 | 24 | | _______________ |
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25 | 25 | | An Act ensuring access to fair and reasonable pharmacy networks. |
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26 | 26 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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27 | 27 | | of the same, as follows: |
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28 | 28 | | 1 SECTION 1. Section 1 of chapter 176Y of the General Laws, as inserted by chapter X of |
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29 | 29 | | 2the Acts of 2024, is hereby amended by inserting after the definition of “Mail-order pharmacy” |
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30 | 30 | | 3the following definition:- |
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31 | 31 | | 4 “Network”, as defined in section 1 of chapter 176O. |
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32 | 32 | | 5 SECTION 2. Said section 1 of said chapter 176Y is hereby further amended by inserting |
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33 | 33 | | 6after the definition of “Pharmacy benefit manager” the following definition:- |
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34 | 34 | | 7 "Steering”, a practice employed by a pharmacy benefit manager or carrier that channels a |
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35 | 35 | | 8prescription to a pharmacy in which a pharmacy benefit manager or carrier has an ownership |
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36 | 36 | | 9interest or with which it is under common ownership, including, but not limited to, retail, mail- |
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37 | 37 | | 10order, or specialty pharmacies. |
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38 | 38 | | 11 SECTION 3. Said chapter 176Y is hereby further amended by inserting at the end thereof |
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39 | 39 | | 12the following 2 sections:- 2 of 2 |
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40 | 40 | | 13 Section 5. (a) A pharmacy benefit manager shall provide a reasonably adequate and |
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41 | 41 | | 14accessible pharmacy benefit manager network for the provision of prescription drugs, which |
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42 | 42 | | 15provides for convenient patient access to pharmacies within a reasonable distance from a |
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43 | 43 | | 16patient’s residence. |
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44 | 44 | | 17 (b) A pharmacy benefit manager may not deny a pharmacy the opportunity to participate |
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45 | 45 | | 18in a pharmacy benefit manager network at preferred participation status if the pharmacy is |
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46 | 46 | | 19willing to accept the terms and conditions that the pharmacy benefit manager has established for |
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47 | 47 | | 20other pharmacies as a condition of preferred network participation status. |
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48 | 48 | | 21 (c) A mail-order pharmacy shall not be considered when determining pharmacy benefit |
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49 | 49 | | 22manager network adequacy under this section. |
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50 | 50 | | 23 Section 6. (a) A pharmacy benefits manager that engages in the practice of steering shall |
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51 | 51 | | 24be subject to a surcharge payable to the division of 10 percent on the aggregate dollar amount it |
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52 | 52 | | 25reimbursed pharmacies in the previous calendar year for prescription drugs in the |
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53 | 53 | | 26commonwealth. |
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54 | 54 | | 27 (b) Any person operating a health plan whose contracted pharmacy benefits manager |
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55 | 55 | | 28engages in the practice of steering shall be subject to a surcharge payable to the division of 10 |
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56 | 56 | | 29percent on the aggregate dollar amount its pharmacy benefit manager reimbursed pharmacies on |
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57 | 57 | | 30its behalf in the previous calendar year for prescription drugs in the commonwealth. |
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