Budget Amendment ID: FY2012-S3-503

EHS 503

Copayment Assistance

Messrs. Moore, Knapik, Hedlund, Timilty, Finegold and Hart moved that the proposed new text be amended by inserting, after Section ____, the following new Section:-

“SECTION ____. Section 3 of chapter 175H of the General Laws is hereby amended by inserting at the end thereof the following two paragraphs:-

"This section shall not apply to a discount, rebate, free product voucher or other reduction in out

of pocket expenses, including but not limited to co-payments and deductibles on a prescription drug, biologic or vaccine provided by a pharmaceutical manufacturing company, as defined in section 1 of chapter 111N, that is made available to an individual, if such is provided directly or electronically to the individual or through a so-called “point of sale” or “mail-in” rebate, or through similar means; provided however, that a pharmaceutical manufacturing company shall neither exclude nor favor any individual pharmacy or restricted network of pharmacies in the design of such discount, rebate, free product voucher or other expense reduction offer to an individual; provided further, that this section does not negate the need for a written prescription as otherwise required by law, nor is it intended to constrain a carrier or a health maintenance organization, as defined in chapter 118G, with regard to how its plan design will treat such discounts, rebates, free product voucher or other reduction in out of pocket expenses, including but not limited to co-payments and deductibles.

For purposes of the Federal Health Insurance Portability and Accountability Act of 1996 and regulations issued there under, nothing in this section shall be deemed to require or allow the use or disclosure of health information in any manner that does not otherwise comply with such Act or such regulations.”