Amendment ID: S2651-9-R1

Redraft Amendment 9

Properly License Specialty Pharmacies and Ensure Access and Safety

Mr. Kennedy moves that the proposed new draft be amended in section 42, by striking out, in line 644, the words “in section 3B of chapter 176D” and inserting in place thereof the following words:- “by the board”; and

in said section 42, by striking out, in line 674, the word “drug” and inserting in place thereof the following words:- “specialty medication”; and

in said section 42, by striking out, in lines 676 and 677, the words “division of insurance may adopt any written policies or procedures or promulgate regulations that the division determines are necessary to implement this section” and inserting in place thereof the following words:- “board shall adopt written policies or procedures or promulgate regulations that the board determines are necessary to implement this section; provided, however, that the board shall define the term “specialty medication” for the purposes of this section”; and

in section 48, by striking out, in lines 734 to 737, inclusive, the words “drugs as defined by this section that are included in its pharmaceutical drug benefits to insureds by any licensed pharmacy; provided, however, that the pharmacy is able to comply with the special handling, administration and monitoring requirements of the specialty drug” and inserting in place thereof the following words:- “medications that are included in its pharmaceutical drug benefits to insureds by any pharmacy licensed under section 39K of chapter 112”; and

in said section 48, by striking out, in line 738, the word “drugs” and inserting in place thereof the following word:- “medications”; and

in section 50, by striking out, in lines 752 to 754, inclusive, the words ““drugs” shall mean a prescription medication that requires special handling, administration or monitoring”” and inserting in place thereof the following words:- “medications” shall mean a specialty medication as defined pursuant to section 39K of chapter 112”; and

by inserting after section 62 the following 2 sections:-

"SECTION 62A. The health policy commission, in consultation with the department of public health, the office of Medicaid, the group insurance commission and the division of insurance, shall study and analyze health insurance payer, including public and private payer, specialty pharmacy networks in the commonwealth. The study shall include: (i) a description of the type of specialty medications most often provided by specialty pharmacies; (ii) the impact of existing health insurance payers’ specialty pharmacy networks on patient access, availability of clinical support, continuity of care, safety, quality, cost sharing and health care costs; and (iii) any recommendations for increasing patient access to and choice of specialty medications, maintaining high-quality specialty pharmacy standards, and meeting the commonwealth’s health care cost containment goals.

The commission shall submit a report of its findings and recommendations to the clerks of the senate and house of representatives, the senate and house committees on ways and means, the joint committee on health care financing and the joint committee on public health not later than July 1, 2023.

SECTION 62B. The regulations required by subsection (d) of section 39K of chapter 112 of the General Laws shall be promulgated not later than December 31, 2022.; and

in section 65, by striking out, in line 1097, the words “December 15, 2022” and inserting in place thereof the following words:- “April 1, 2023”.