Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S694

Introduced
2/27/25  

Caption

Empowering health care consumers

Impact

With the passage of S694, state laws relating to health insurance disclosure will be updated to require that formularies are not only posted on insurance providers' websites but also be actively updated within 72 hours of any change. This measure is intended to facilitate easier access for consumers to pertinent information, which can assist them in making informed choices regarding their health care and prescriptions. The Division of Insurance is tasked with developing a standard template to ensure consistency across all health care service plans in conveying this critical information.

Summary

S694, titled 'An Act Empowering Health Care Consumers', aims to enhance transparency in health insurance plans regarding the utilization of formularies for prescription drugs. The bill mandates that health insurance providers must notify enrollees in their coverage documents whether their plan employs a formulary. If a formulary is used, it must include comprehensive details on its structure, such as how drugs are included or excluded, and the frequency with which the formulary is reviewed. This change represents a significant step towards ensuring consumers are well-informed about their health coverage options.

Contention

While proponents of S694 argue that it bolsters consumer rights by improving access to information, some industry advocates express concerns about the administrative burden it places on insurers. There is apprehension that the mandate for rapid updates to formularies could lead to increased operational costs that may be passed on to consumers. Furthermore, the requirements for detailed disclosures might overwhelm individuals unfamiliar with insurance language, potentially diluting the intended benefits of transparency.

Companion Bills

No companion bills found.

Previously Filed As

MA S2121

Establishing the official marine flora of the Commonwealth

MA S1492

Relative to newborn infant safe sleep practices

MA S1809

Relative to special needs trusts and pensions

MA S1060

Relative to the charitable immunity cap for cases involving sexual abuse

MA S23

Enabling the appointment of alternates to the Swampscott Conservation Commission

MA S1812

Relative to providing for domestic partners through public employee pensions

MA S1813

Relative to the funding ratio of the public employee retirement system

MA S1943

Relative to rolling stock

Similar Bills

MA H1155

Empowering health care consumers

AZ SB1102

Pharmacy benefits; prescribing; exemption

MD SB393

Health Insurance - Prescription Drug Formularies and Coverage for Generic Drugs and Biosimilars

MN SF1806

Certain formulary changes during the plan year prohibition provision and medical assistance program formulary changes implementation for certain enrollees prohibition provision

ME LD1128

An Act to Modernize the Formulary for Naturopathic Doctors

VA HB2329

Health insurance; prescription drug formularies.

MN SF2645

Formulary Committee members with a potential conflict of interest participation in committee communications and discussions authorization provision, public comment process for recommendations to the Formulary Committee development by the commissioner of human services requirement provision, and Minnesota Rare Disease Advisory Council expertise sought by the Formulary Committee requirement provision

TX SB895

Relating to the transparency of certain information related to prescription drug coverage provided by certain health benefit plans.