H 4488
An Act relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth
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 increase transparency and fairness in how pharmacy benefit managers (PBMs) reimburse pharmacies in Massachusetts. It establishes rules for PBMs to update their lists of drugs with maximum allowable costs, requiring them to provide pharmacies with timely notifications and a process for appealing reimbursement rates. The bill also mandates that PBMs reimburse pharmacies at least equal to the amount they reimburse affiliated entities and includes provisions to address situations where pharmacies are underpaid due to PBM practices.
Key provisions
- PBMs must list drugs on their ‘maximum allowable cost list’ based on therapeutic and pharmaceutical equivalence ratings.
- PBMs must update their lists within 7 days of a 10% cost increase or methodology change.
- Pharmacies have a 7-business day window to file administrative appeals regarding reimbursement rates.
- PBMs must respond to appeals within 7 business days, providing the National Drug Code and wholesaler information.
- If an appeal is upheld, the PBM must adjust the maximum allowable cost to match the pharmacy’s acquisition cost.
- PBMs cannot reimburse pharmacies less than they reimburse affiliated entities.
- Pharmacies can decline to provide services if reimbursement rates are insufficient.
- Violations of the bill are considered deceptive and unfair trade practices.
Who is affected
- Pharmacies
- Pharmacy Benefit Managers (PBMs)
- Patients
- Pharmaceutical Wholesalers
Sponsors
Official sponsors from legislative records.
Primary sponsor
Joint Committee on Financial Services
Cosponsor
Alyson M. Sullivan-Almeida
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.4488 194th (Current)
An Act relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth
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.4488
| Date | Branch | Action |
| 9/18/2025 | House | Reported from the committee on Financial Services |
| 9/18/2025 | House | New draft of H1330 |
| 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.1330 194th (Current)
An Act relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth
H.3787 192nd (2021 - 2022)
An Act relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth
H.1247 193rd (2023 - 2024)
An Act relative to pharmacy benefit managers reimbursements to pharmacies in the Commonwealth
H.1167 194th (Current)
An Act to enact pharmacy benefit manager duties
H.1234 194th (Current)
An Act relative to pharmacy benefit managers
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.