H 4491
An Act relative to non-medical switching
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Sign in to take action- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill, titled ‘An Act relative to non-medical switching,’ aims to protect patients from being forced to switch to less expensive prescription drugs if their doctor continues to prescribe them for medical reasons. It establishes rules for health benefit plans, preventing them from making changes to their formularies that would negatively impact patients who are medically stable on their current medications. The bill also outlines a process for obtaining coverage exemptions and ensures continuity of care for those who experience a discontinued health benefit plan.
Key provisions
- Prohibits health benefit plans from limiting or excluding prescription drug coverage for patients medically stable on their current prescribed drug.
- Requires health carriers to provide a process for obtaining coverage exemption determinations to ensure continuity of care.
- Establishes a timeframe (72 hours, with exceptions) for health carriers to respond to coverage exemption requests.
- Protects coverage for patients enrolled in a discontinued health benefit plan if they enroll in a comparable plan.
- Specifies criteria for denying coverage exemptions, including drug manufacturer discontinuance or potential discontinuance.
- Requires health carriers to authorize coverage no more restrictive than that offered in a discontinued plan.
- Defines key terms related to non-medical switching, such as ‘nonmedical switching,’ ‘formulary,’ and ‘coverage exemption.’
- Provides for enforcement by the Commissioner of Insurance.
Who is affected
Sponsors
Official sponsors from legislative records.
Primary sponsor
Joint Committee on Financial Services
Cosponsor
Michael S. Day
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Bill H.4491 194th (Current)
An Act relative to non-medical switching
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Bill Information
Bill Information
Sponsor: Joint Committee on Financial Services Status: Referred to House Committee on Ways and Means
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Bill History Cosponsors Committee Vote Fiscal Note Committee Summary
Bill History
Displaying 4 actions for Bill H.4491
| Date | Branch | Action |
| 9/18/2025 | House | Reported from the committee on Financial Services |
| 9/18/2025 | House | New draft of H1125 |
| 9/18/2025 | House | Reported favorably by committee and referred to the committee on Health Care Financing |
| 12/4/2025 | House | Committee recommended bill ought to pass and referred to the committee on House Ways and Means |
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