Bill S.681

SENATE DOCKET, NO. 2128 FILED ON: 1/20/2023

SENATE . . . . . . . . . . . . . . No. 681

By Mr. Montigny, a petition (accompanied by bill, Senate, No. 681) of Mark C. Montigny for legislation to combat COVID-19 vaccine price gouging. Financial Services.

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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An Act to combat COVID-19 vaccine price gouging.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 6A of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting after section 16CC the following section:-

Section 16DD. (a) Notwithstanding any general or special law to the contrary, the secretary of the executive office of health and human services, in consultation with the secretary of administration and finance, shall develop a coordinated, aggregate COVID-19 vaccine procurement plan to manage and administer the purchase, disbursement, and reimbursement of COVID-19 vaccines for all health care programs administered by the commonwealth and for members of all health coverage plans funded or subsidized, in whole or in part, by the commonwealth. The aggregate procurement plan shall maximize cost savings and efficiencies, enhance affordable access to COVID-19 vaccination, and be designed to improve health outcomes while providing access to uninsured residents.

(b) Notwithstanding any general or special law to the contrary, as part of the aggregate procurement plan, the secretary shall seek competitive bids for the supply of COVID-19 vaccines necessary to meet the needs of health care programs administered by the commonwealth and for individuals insured under health coverage plans funded or subsidized, in whole or in part, by the commonwealth as well as uninsured residents. The secretary may coordinate with other states and jurisdictions for the implementation of the aggregate procurement plan in order to maximize cost savings. The secretary shall establish an annual maximum purchase price for each dose of COVID-19 vaccine under the aggregate procurement plan, which shall not exceed the lesser of the following:

(1) cost per dose paid for by the Centers for Disease Control and Prevention; or

(2) reimbursement rate paid by the Centers for Medicare and Medicaid Services.

(c) The secretary shall implement the aggregate procurement plan not later than 180 days after the effective date of this act and shall submit by April 15 of each year a report detailing the coordinated aggregate or bulk purchasing arrangement results for the previous fiscal year to the clerks of the house of representatives and senate, the joint committee on public health, the joint committee on health care financing and the house and senate committees on ways and means. The report shall include, but not be limited to, a review of the aggregate procurement plan’s achievement relative to:

(1) cost savings achieved during the previous fiscal year;

(2) administrative costs relating to the management of the program for the previous fiscal year;

(3) any recommendations for enhancing cost savings, reducing inefficiencies, and improving access; and

(4) a cost-benefit analysis of the inclusion of other entities, including but not limited to not-for-profit healthcare providers, county, municipal, and quasi-governmental entities within the aggregate procurement plan.

SECTION 2. Chapter 32A of the General Laws, as so appearing, is hereby amended by adding the following section:-

Section 31. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for annual vaccination against COVID-19; provided that said coverage shall not be subject to any deductible, co-insurance, or co-payment.

SECTION 3. Chapter 118E of the General Laws, as so appearing, is hereby amended by inserting after section 10N the following section:-

Section 10O. The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for annual vaccination against COVID-19; provided, that said coverage shall not be subject to any cost sharing.

SECTION 4. Chapter 175 of the General Laws, as so appearing, is hereby amended by inserting after section 47PP the following section:-

Section 47QQ. A policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides medical expense coverage shall provide coverage for annual vaccination against COVID-19; provided, that said coverage shall not be subject to any deductible, co-insurance, or co-payment.

SECTION 5. Chapter 176A of the General Laws, as so appearing, is hereby amended by inserting after section 8QQ the following section:-

Section 8RR.Any contract between a subscriber and a corporation under an individual or group hospital service plan delivered, issued or renewed within the commonwealth shall provide coverage for annual vaccination against COVID-19; provided that said coverage shall not be subject to any deductible, co-insurance, or co-payment.

SECTION 6. Chapter 176B of the General Laws, as so appearing, is hereby amended by inserting after section 4QQ the following section:-

Section 4RR. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for annual vaccination against COVID-19; provided, that said coverage shall not be subject to any deductible, co-insurance, or co-payment.

SECTION 7. Chapter 176G of the General Laws, as so appearing, is hereby amended by inserting after section 4II the following section:-

Section 4JJ. Any individual or group health maintenance contract shall provide coverage for annual vaccination against COVID-19; provided, that said coverage shall not be subject to any deductible, co-insurance, or co-payment.

SECTION 8. Notwithstanding any general or special law to the contrary, the health policy commission, in consultation with the center for health information and analysis, the executive office of health and human services, and the division of insurance, shall produce interim and final reports on the accessibility and affordability of COVID-19 vaccines in the commonwealth and the effects of capping copayments and eliminating deductible and co-insurance requirements on health care access and system cost.

The interim and final report shall include, but not be limited to: (i) rates of COVID-19 vaccine utilization; (ii) an analysis of the use of COVID-19 vaccination, broken down by patient demographics, geographic region and insurance coverage; (iii) annual plan costs and member premiums; (iv) the average list price of COVID-19 vaccines, broken down by manufacturer; (v) the average increase in annual plan costs and member premiums due to vaccine list price increases; (vi) the impact upon the health care cost growth benchmark; (vii) an analysis of the impact of eliminating co-payments, deductibles, and co-insurance requirements for COVID-19 vaccination on patient access to and cost of care by patient demographics and geographic region; (viii) out-of-pocket costs incurred by uninsured individuals; (ix) additional barriers to accessing COVID-19 vaccination for uninsured individuals and policy recommendations for resolving such barriers; (x) federal and state subsidies provided to develop COVID-19 vaccines, broken down by manufacturer; (xi) current cost to produce each vaccine dose as of January 1, 2023; and (xii) total profits realized from the COVID-19 vaccine between July 1, 2020 and January 1, 2023, broken down by manufacturer. The interim report, including any recommendations for expanding access to COVID-19 vaccination for uninsured individuals, shall be filed with the clerks of the house of representatives and senate, the joint committee on public health, the joint committee on health care financing, and the house and senate committees on ways and means not later than 9 months after the effective date of this act. The final report, including any recommendations for expanding access to COVID-19 vaccination for uninsured individuals, shall be filed with the clerks of the house of representatives and senate, the joint committee on public health, the joint committee on health care financing, and the house and senate committees on ways and means not later than 18 months after the effective date of this act.

Name:	District/Address:
Mark C. Montigny	Second Bristol and Plymouth