Amendment #897 to H5500

Protecting 340B Providers in the Medicaid Program

Mrs. Lipper-Garabedian of Melrose moves to amend the bill by adding the following section:

“SECTION XXXX. Section 13L of chapter 118E of the General Laws is hereby amended by striking the section in its entirety and replacing with the following:

“The secretary of health and human services shall not take any actions, including through managed care entities as defined in section 13D ½ of this chapter or a carve-out of the pharmacy benefit from managed care entities, that restrict or limit reimbursement or coverage of a drug purchased under 42 U.S.C. 256b when furnished to MassHealth members, unless the specific drug subject to restriction or limitation (i) costs $100,000 or more per utilizer per year and is one of up to 25 drugs designated by the executive office for exclusion from MassHealth members, or (ii) is one of the seven GLP-1 Agonist drugs designated by the executive office that is restricted from reimbursement if purchased under 42 U.S.C. 256b effective January 1, 2026.”.

Additional co-sponsor(s) added to Amendment #897 to H5500

Protecting 340B Providers in the Medicaid Program