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Bill

S 687

An Act ensuring access to fair and reasonable pharmacy networks

194th Legislature (2025-2026) Introduced by Cynthia Creem

S 687 establishes pharmacy network adequacy standards requiring Massachusetts insurers and PBMs to maintain fair, reasonable patient access to medications and pharmacies statewide.

Accompanied a study order, see S3067
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Bill Summary · S 687

Legislative bill overview

S 687 aims to regulate pharmacy network adequacy in Massachusetts by establishing standards for "fair and reasonable" pharmacy networks offered by health insurers and pharmacy benefit managers (PBMs). The bill would require insurers to maintain sufficient pharmacy access and prevent discriminatory network practices that limit patient choice or create unreasonable barriers to medication access.

Why is this important

Pharmacy network restrictions can force patients to travel excessive distances, use unfamiliar pharmacies, or switch medications if their preferred pharmacy is excluded from their plan. This directly impacts medication adherence, healthcare costs, and patient outcomes—particularly for rural residents and those with chronic conditions requiring specific pharmacy services.

Potential points of contention

  • Defining "fair and reasonable": The bill lacks specific network adequacy metrics (distance standards, pharmacy density ratios), leaving enforcement vague and potentially subject to litigation over what constitutes compliance
  • PBM and insurer costs: Broader networks increase operational costs, which may be passed to consumers through higher premiums, potentially contradicting the goal of affordability
  • Market competition concerns: Insurers may argue that strict network standards reduce their ability to negotiate favorable rates and innovate with selective contracting models

Compiled from official sources — confirm details with the bill’s official record.

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