MA H1155

Requires health insurance plans to notify enrollees whether they use a formulary, explain how drugs are included or excluded, and disclose how often the formulary is reviewed

Mandates insurers post searchable formularies on their websites and update them within 72 hours of any changes, using a standard template developed by the Division of Insurance

Requires formularies to disclose prior authorization requirements, step therapy requirements, and utilization management rules for each listed drug

Requires disclosure of prescription drug cost-sharing amounts, either as exact dollar figures or using a tiered symbol system ($ for under $100 up to $$$$$ for over $1,000), including separate disclosure for mail-order pharmacy costs

Applies to all major insurance types in Massachusetts: commercial insurance (Chapter 175), Blue Cross Blue Shield plans (Chapters 176A and 176B), HMOs (Chapter 176G), and Group Insurance Commission coverage for state employees (Chapter 32A)