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Bill H.779
Section 13L of chapter 118E of the General Laws is hereby amended by striking the section in its entirety and replacing with the following:
“The secretary of health and human services, hereinafter “the secretary”, shall not restrict or limit an eligible hospital’s access to the discounted purchase of prescription drugs to the full extent permitted under section 340B of the Public Health Service Act, as codified under 42 U.S.C. 256b unless the secretary provides the following not less than 180 days before the proposed effective date of the limitation or restriction: (i) notice to eligible hospitals of the proposed restriction or limitation; and (ii) a report with the joint committee on health care financing and the senate and house committees on ways and means detailing: (A) the proposed restriction or limitation; (B) the anticipated aggregate savings to the commonwealth; (C) the estimated fiscal impact of the restriction or limitation on each affected hospital; and (D) the manner in which the secretary plans to mitigate the fiscal impact, which may include measures to maintain savings already achieved by providers under said 42 U.S.C. 256b. In addition to the foregoing, the secretary shall not take any actions, including through managed care entities as defined in section 13D ½ of this chapter, that restrict or limit reimbursement or coverage of a drug purchased under 42 U.S.C. 256b when furnished to MassHealth members, unless the specific drug subject to restriction or limitation (i) costs $100,000 or more per utilizer per year and is one of up to 25 drugs designated by the executive office for exclusion from MassHealth members, or (ii) is one of the seven GLP-1 Agonist drugs designated by the executive office that is restricted from reimbursement if purchased under 42 U.S.C. 256b effective July 1, 2024.”
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