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Read. Follow. Verify.Massachusetts Bill Regulates Pharmacy Benefit Managers and Reimbursement Rates
Last action · January 29, 2026: Accompanied a study order, see S2931Sponsors: Bruce Tarr and 1 other
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What This Bill Would Do
This bill establishes new pricing transparency, reimbursement floors, and appeals processes for s operating in Massachusetts, requiring that drug reimbursement rates equal or exceed a pharmacy's acquisition cost and prohibiting retroactive discounts. It also mandates that MassHealth managed care organizations reimburse pharmacies at rates matching the MassHealth Pharmacy Provider Manual.
The measure changes financial and operational rules for pharmacies and s in Massachusetts, affecting drug reimbursement calculations, allowable list criteria, and contract transparency.
- Pharmacy benefits managers act as intermediaries between health insurance plans and pharmaceutical manufacturers, negotiating pricing and managing drug formularies. context
- MassHealth is the state Medicaid and Children's Health Insurance Program (CHIP) for Massachusetts. context
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
pharmacies
Pharmacies receive new reimbursement protections, mandatory minimum payment floors tied to acquisition costs, and a formal appeals process for disputed drug prices.
pharmacy benefits managers
Pharmacy benefits managers must comply with updated cost-listing criteria, maintain frequent list updates, process appeals within strict timelines, and refrain from retroactive discounts.
MassHealth Managed Care Organizations and Accountable Care Organizations
These entities are required to reimburse pharmacies at the rates specified in the MassHealth Pharmacy Provider Manual.
pharmacists
Pharmacists are explicitly protected from contract clauses that prohibit them from disclosing treatment alternatives, cost shares, or pricing information to patients.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What criteria must a drug meet before being placed on a maximum allowable cost list?
How long does a pharmacy have to appeal a drug cost determination?
Who is responsible for enforcing this legislation?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
6 actions- Jan 29, 2026SenateAccompanied a study order, see S2931
- Dec 4, 2025SenateCommitteeBill reported favorably by committee and referred to the committee on Health Care Financing
- Aug 28, 2025JointHearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual<br> <span style="color: blue; font-style: italic;">Hearing updated to New End Time</span>
- Apr 23, 2025JointHearing scheduled for 04/29/2025 from 10:00 AM-02:00 PM in A-2
- Feb 27, 2025HouseHouse concurred
- Feb 27, 2025SenateCommitteeReferred to the committee on Financial Services
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Shift Toward Enhanced PBM Transparency and Acquisition Cost Floors
The bill establishes strict requirements ensuring that pharmacy reimbursement matches or exceeds acquisition costs while prohibiting retroactive discounts.
Connected Entities
Sources
malegislature.gov
Analysis Score
0–100- Significance75How much this matters to a regular citizen
- Controversy65Intensity of disagreement among stakeholders
- Entertainment10Compellingness for a non-policy-wonk reader
- Buzz40Current news / social attention level
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