Amendment #37 to H4891

340B Covered Entity Transparency

Mr. MacGregor of Boston moves to amend the amendment by adding the following new section:

SECTION 1. Chapter 12C of the General laws is hereby amended by inserting after section 9, the following new section:-

Section 9A.

A. DEFINITIONS. For the purposes of this section:

“340B program,” means the federal drug pricing program described in 42 U.S.C. 256b.

“340B drug,” means a covered outpatient drug that has been subject to any offer for reduced prices by a manufacturer pursuant to 42 U.S.C. 256(b)(a)(1), and is purchased by a covered entity.

“Center for Health Information and Analysis,” the center established by the provisions of section 2 of this chapter.

“Charity care,” the term in line 23 of worksheet S–10 to the Medicare cost report or in any successor form.

“Covered entity,” a covered entity as defined in 42 U.S.C. 256b(a)(4).

“Covered outpatient drug,” a covered outpatient drug, as defined in 42 U.S.C. 1396r-8(k)(2).

B. Beginning on April 1, 2026, each covered entity shall annually report to the Center for Health Information and Analysis, in a form and manner determined by the center, the following information about the prior year regarding the covered entity and each offsite outpatient facility associated with the covered entity:

Delineated by form of insurance or payor type, including but not limited to Medicaid, Medicare, commercial insurance, and uninsured:

Aggregate acquisition cost paid for all 340B Drugs;

Aggregated payments received by insurers or payors for all 340B Drugs; and

Total number of prescriptions and percentage of the covered entity’s prescriptions that were filled with 340B Drugs;

Total operating costs of the covered entity, including itemized costs for:

Implementing direct pass through of 340B program discounts to patients of the covered entity in the form of lower cost sharing for 340B Drugs at the point of dispensing or administration;

Implementing a sliding fee scale for 340B Drugs at the point of sale for patients with incomes less than 200% of the Federal Poverty Guidelines; and

Charity care;

Total payments made by the covered entity or any agent of the covered entity to:

Any pharmacies under contract with the covered entity to dispense 340B drugs for340B program-related services and other functions;

Third-party administrators, including pharmacy benefit managers, for managing any components of the covered entity’s 340B program; and

Any other third parties in connection with 340B program-related compliance, legal, educational, and/or administrative costs;

Total number of pharmacies under contract with the covered entity to dispense 340B drugs, and:

Number of such pharmacies located out-of-state and the states in which such out-of-state pharmacies are located;

Total number of prescriptions and orders for 340B Drugs filled by the covered entity and by each offsite outpatient facility associated with the covered entity, and the percentage of such prescriptions or orders that were filled at such pharmacies, delineated by in-state and out-of-state pharmacies;

Total remuneration paid to or retained by such pharmacies or their affiliates for any 340B program-related services performed on behalf of the covered entity and each offsite outpatient facility associated with the covered entity; and

The percentage change in remuneration described in subsection (b)(4)(iii) for the prior year compared to the year before that.

An officer of the covered entity shall certify the completeness and accuracy of the report submitted pursuant to subsection (b).

The Center for Health Information and Analysis post all reports submitted by covered entities pursuant to subsection (b) on a publicly accessibly website.

SECTION 2. This act shall take effect upon its passage.

Additional co-sponsor(s) added to Amendment #37 to H4891

340B Covered Entity Transparency