H1334 — An Act to enact pharmacy benefit manager duties

Summary

An Act to enact pharmacy benefit manager duties

Bill Text

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AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill creates Chapter 175N, establishing duties and regulations for pharmacy benefit managers in relation to enrollees, health benefit plans, and providers.

• Chapter 175M

  CHAPTER 175N. Pharmacy Benefit Manager Duty of Care.

  This creates a new chapter in the General Laws addressing pharmacy benefit manager responsibilities.

• Chapter 175N, Section 1

  Definitions pertaining to 'Carrier', 'Commissioner', 'Division', 'Enrollee', 'Health benefit plan', 'Person', 'Pharmacy benefit management fee', 'Pharmacy benefit management service', 'Pharmacy benefit manager', 'Pharmacy benefit manager duty', 'Provider', 'Related entity', and 'Spread pricing'.

  This introduces key definitions needed for the new regulations surrounding pharmacy benefit managers.

• Chapter 175N, Section 2

  Pharmacy Benefit Manager Duties including duties to enrollees, health benefit plans, and providers with an emphasis on transparency and fair dealing.

  This delineates the responsibilities that pharmacy benefit managers must uphold towards enrollees, health benefit plans, and providers.

• Chapter 175N, Section 2(b)

  Conflicts of interest where the duty to enrollees is primary over other duties.

  This establishes the hierarchy of responsibility favoring enrollees in cases of conflicting duties.

• Chapter 175N, Section 3

  Savings clause ensuring that if any portion of the Act is deemed invalid, the remainder remains enforceable.

  This preserves the integrity of the Act by allowing unaffected sections to remain in force even if part is invalidated.

• Chapter 175N, Section 4

  Penalties for violations of the chapter or regulations, including monetary penalties and license actions.

  This sets consequences for pharmacy benefit managers that do not comply with the new regulations.

• Chapter 175N, Section 5

  Authority for the commissioner to adopt necessary policies, procedures, or regulations.

  This grants the commissioner the power to create additional rules to implement the new chapter effectively.

Sponsors

• Chynah Tyler · Primary

Subjects