H 4493
An Act to ensure access to prescription medication and community pharmacies
Take action
Record your position on this measure.
Sign in to record your position, submit testimony, or contact your legislator.
Sign in to take action- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill aims to improve access to prescription medications and support community pharmacies in Massachusetts. It establishes rules for pharmacy benefit managers (PBMs) regarding payment practices, cost controls, and network pharmacy participation. The bill seeks to ensure fair reimbursement rates for pharmacies and prevent PBMs from steering patients towards specific pharmacies, particularly those affiliated with the PBM. It also includes provisions for transparency in pricing and appeals processes.
Key provisions
- Establishes minimum payment rates for pharmacy services, aligning them with the Massachusetts Medicaid Program.
- Prohibits pharmacy steering by PBMs, preventing them from directing patients to preferred pharmacies.
- Requires PBMs to provide pharmacies with detailed information about the sources used to determine maximum allowable costs.
- Creates a process for pharmacies to appeal cost determinations and ensures retroactive adjustments if an appeal is successful.
- Sets maximum allowable costs for drugs, based on FDA ratings and availability of generic alternatives.
- Prohibits PBMs from charging community pharmacies for credentialing.
- Requires PBMs to report denied pharmacy appeals annually.
- Allows pharmacies to use signature logs to validate prescription intent during audits.
Who is affected
- Community Pharmacies
- Pharmacy Benefit Managers (PBMs)
- Patients in Massachusetts
- Health Benefit Plans
Sponsors
Official sponsors from legislative records.
Primary sponsor
Joint Committee on Financial Services
Cosponsors
Carole A. Fiola
Patrick Joseph Kearney
Arguments in favor
Reasons to support this legislation.
No arguments in favor have been submitted.
Submit yoursArguments opposed
Reasons to oppose this legislation.
No arguments opposed have been submitted.
Submit yoursRead the latest version inline or switch to a previous version.
Bill H.4493 194th (Current)
An Act to ensure access to prescription medication and community pharmacies
View Text Print Preview Download PDF
Bill Information
Bill Information
Sponsor: Joint Committee on Financial Services Status: Referred to Joint Committee on Health Care Financing
Tabs
Bill History Cosponsors Committee Vote Committee Summary
Bill History
Displaying 5 actions for Bill H.4493
| Date | Branch | Action |
| 9/18/2025 | House | Reported from the committee on Financial Services |
| 9/18/2025 | House | New draft of H1157 |
| 9/18/2025 | House | Reported favorably by committee and referred to the committee on Health Care Financing |
| 12/8/2025 | House | Reporting date extended to Wednesday, March 18, 2026 |
| 3/19/2026 | House | Reporting date extended to Monday, June 15, 2026 |
Similar Bills
H.1157 194th (Current)
An Act to ensure access to prescription medication and community pharmacies
S.831 194th (Current)
An Act to ensure access to prescription medication and community pharmacies
H.1326 194th (Current)
An Act to ensure access to prescription medications
H.1092 194th (Current)
An Act to ensure affordable prescription medications through accountability standards
H.4489 194th (Current)
to ensure affordable prescription medications through accountability standards
The information contained in this website is for general information purposes only. The General Court provides this information as a public service and while we endeavor to keep the data accurate and current to the best of our ability, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk.