An Act ensuring pharmacy access

194th Legislature (2025-2026) Introduced by Colleen Garry

Protects pharmacy access: any registered pharmacy/pharmacist that accepts contract terms cannot be denied as a preferred provider, boosting in-network access for patients.

Accompanied a study order, see H5223

Summary: An Act ensuring pharmacy access (H 4181)

Overview

H 4181, titled An Act ensuring pharmacy access, proposes a straightforward nondiscrimination provision to protect pharmacist and pharmacy participation in preferred provider networks. The bill adds a new rule to Chapter 176I of the General Laws ensuring pharmacies and pharmacists cannot be denied the right to participate as preferred providers if they are registered and accept the contract terms.

Purpose and intent

To prevent discrimination against pharmacies or pharmacists when they seek to join or participate in preferred provider networks.

To ensure parity with other preferred or contracting providers, so long as the pharmacy/pharmacist meets registration and contract terms.

The aim is to improve pharmacy access within health plan networks for patients.

Key provision

Amends Chapter 176I, Section 4 by adding: “No pharmacy or pharmacist shall be denied the right to participate as a preferred provider under the same terms and conditions currently applicable to all other preferred or contracting providers provided the pharmacy or pharmacist is registered and accepts the terms and conditions of the contract.”

In practical terms, if a pharmacy or pharmacist is properly registered and agrees to the contract terms, they may not be barred from joining or remaining in the preferred provider network on grounds that differentiate them from other providers.

Who is affected

Primary: Pharmacies and pharmacists seeking to participate as preferred providers.

Secondary: Health plans, insurers, and other entities that operate preferred provider networks and contract with providers.

Patients may benefit indirectly through improved access to in-network pharmacy services.

Procedural and timeline notes

Introduced: March 27, 2025.

Status history: Referred to House Rules on 3/27/2025; Senate concurrence noted 6/2/2025; subsequent committee actions and reporting referenced.

Hearing: Scheduled for October 1, 2025 (various updates and venue changes noted; final timing listed as 10:30 AM–1:00 PM in B-1 with virtual option adjustments).

Related matter: A related bill (HD 4409) is listed as replacing this matter; context suggests similar or overlapping provisions.

Related information

The bill appears to be a companion effort to earlier similar proposals and is linked to HD 4409 in current materials.

It amends a standing statute (Chapter 176I) and does not specify funding or regulatory enforcement beyond contract terms and participation rights.

Potential impact

Positive: Enhanced access to pharmacy services within insurance networks; reduced barriers for pharmacies to participate as preferred providers.

Neutral to monitoring: Health plans may need to review and ensure their contracting practices comply with the new standard to avoid denial of participation.

If you’d like, I can provide a side-by-side comparison with current Massachusetts law or draft a one-page briefing for stakeholders.