Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1167

Introduced
2/27/25  
Refer
2/27/25  

Caption

To enact pharmacy benefit manager duties

Impact

If enacted, H1167 will have significant implications for the pharmaceutical and healthcare sectors in Massachusetts. The bill mandates that PBMs provide clear and honest information regarding the fees and pricing associated with prescription drugs and require them to disclose any conflicts of interest to health benefit plans, enrollees, and providers. This move is expected to increase accountability within the pharmacy benefit management structure, thereby facilitating better healthcare outcomes and potentially decreasing costs for consumers through increased competition and more equitable practices.

Summary

House Bill H1167 aims to establish specific duties for pharmacy benefit managers (PBMs) operating within the Commonwealth of Massachusetts. The legislation seeks to amend Chapter 176Y of the General Laws by introducing a new section that outlines the various responsibilities PBMs have towards health benefit plans, enrollees, and providers. By enforcing these duties, the bill promotes transparency in pharmacy benefit management, highlighting the importance of managing conflicts of interest and ensuring fair dealings in prescription drug pricing and other related services.

Contention

Despite the positive objectives of H1167, discussions around the bill may face contention. Critics could argue that imposing stringent duties on PBMs may lead to increased operational costs, which could be transferred to consumers in the form of higher premiums or drug costs. Additionally, there may be concerns about the regulatory burden placed on these entities, potentially affecting the availability of certain services or the speed at which drug pricing negotiations occur. As the bill progresses through legislative channels, these discussions may reflect broader concerns regarding the balance between regulation and industry flexibility.

Companion Bills

No companion bills found.

Previously Filed As

MA H1334

To enact pharmacy benefit manager duties

MA H1082

To enact the pharmacy benefit manager compensation reform

MA S3059

Imposes certain duties, transparency, and accountability from pharmacy benefits managers and pharmacy benefits management services.

MA H1234

Relative to pharmacy benefit managers

MA H1330

Relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth

MA H4488

Relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth

MA HB2773

Health insurance; cost-sharing, pharmacy benefits managers, compensation and duties, civil penalty.

MA SB1078

Health insurance; cost-sharing, pharmacy benefits managers, compensation and duties, civil penalty.

MA HB1041

Health insurance; cost-sharing, pharmacy benefits managers' compensation and duties, civil penalty.

MA SB413

Health insurance; cost-sharing, pharmacy benefits managers, compensation and duties, civil penalty.

Similar Bills

KS HB2551

Enacting the Kansas pharmacy services administrative organization act.

MS HB1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

MS HB558

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

AR SB593

To Amend The Arkansas Pharmacy Benefits Manager Licensure Act; And To Create The Pharmacy Services Administrative Organization Act.

NJ S2345

"Patient and Provider Protection Act."

AR SB475

To Establish The Pharmacy Services Administrative Organization Act; And To Regulate Pharmacy Services Administrative Organizations.

MS HB1119

Pharmacy benefit managers; revise provisions related to.

MS SB2677

Pharmacy Benefit Prompt Pay Act; define requirements for pharmacy benefit managers and pharmacy services administrative organizations.