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MA H4496
Bill
Status
9/18/2025
Primary Sponsor
Joint Committee on Financial Services
Click for details
AI Summary
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Health insurers must apply pro-rated daily cost-sharing for partial prescription supplies when a prescriber or pharmacist determines it is in the patient's best interest and the patient agrees, for the purpose of medication synchronization
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Insurers cannot deny coverage for partial prescription fills dispensed by network pharmacies for medication synchronization purposes
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Health plans must allow pharmacies to override "refilled too soon" denial codes when the early refill is for medication synchronization
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Pharmacies must receive full dispensing fees for partially filled prescriptions, even when the patient's copay is pro-rated for the smaller supply
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Applies to all individual and group health insurance policies providing prescription drug coverage under Massachusetts General Laws chapters 32A, 175, 176A, 176B, 176G, 176I, 176J, and 176Q
Legislative Description
To help patients and reduce health care costs by ensuring patient adherence to medications
Last Action
Reported favorably by committee and referred to the Joint Committee on Health Care Financing
9/18/2025