An Act relative to MassHealth managed care pharmacy benefit reimbursement rates
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Overview
This bill addresses the reimbursement rates that MassHealth managed care organizations pay pharmacies for prescription drugs. It aims to establish a process for reviewing and adjusting these rates to ensure they are fair and sustainable, considering the costs of medications and the needs of patients. The bill seeks to improve the affordability of prescription drugs for MassHealth recipients. Specifically, it focuses on how managed care organizations are reimbursed for pharmacy services.
Key provisions
- Establishes a process for reviewing managed care pharmacy reimbursement rates.
- Requires MassHealth to consider the cost of medications when setting rates.
- Directs MassHealth to evaluate the impact of reimbursement rates on patient access to medications.
- Mandates the creation of a working group to study and recommend changes to the reimbursement system.
Who is affected
- MassHealth recipients
- Managed care organizations contracted with MassHealth
- Pharmacies in Massachusetts
- Patients in Massachusetts
Notable changes
- The bill introduces a formal review process for pharmacy reimbursement rates.
- It requires MassHealth to factor in medication costs during rate setting.
Fiscal impact
The bill may impact the financial resources of managed care organizations and MassHealth, requiring further analysis to determine the overall fiscal effect.
Bill text
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Sponsors
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3 on record
Primary sponsor
Cosponsors
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