Bill
HD 2246
Creates a 10-member temporary commission to study MAC lists used by payers and PBMs, assess impact, and recommend standardization and transparency within 180 days.
HD 2246 — An Act establishing a commission to study maximum allowable costs lists
Overview
HD 2246 proposes creating a temporary special commission to study maximum allowable costs (MAC) lists used by payers and pharmaceutical benefit managers (PBMs) to determine the maximum amount a health plan will pay for prescription drugs. The bill does not adopt new MAC pricing itself but directs a fact-finding panel to assess current practices, financial impacts, and potential standardization and transparency improvements.
Key provisions
- Establishment of a special commission to investigate MAC lists and their use by payers and PBMs.
- Scope of review includes: how MAC lists are determined and used, their financial implications, potential for industry-wide standardization, and transparency in the development and application of MAC lists.
- The commission would produce findings and, if appropriate, a draft of follow-up legislation.
Commission composition
The commission would have 10 members:
- Secretary of Health and Human Services (or designee) as chair.
- Speaker of the House (or designee).
- Senate President (or designee).
- Minority leaders of the House and Senate (or designees).
- A representative from the Massachusetts Association of Health Plans.
- A representative from the Massachusetts Pharmacists Association.
- One advocate for health care providers (appointed by the Governor).
- One advocate for pharmaceutical companies (appointed by the Governor).
- One advocate for pharmaceutical benefit managers (appointed by the Governor).
Duties and timeline
- The commission must submit its report and findings, along with any draft legislation, to the House Ways and Means Committee, the Joint Committee on Health Care Financing, and the clerks of the House and Senate within 180 days of the act’s passage.
- The bill envisions a focused, one-time review rather than creating a standing regulatory body.
Potential impact
- The bill would illuminate current MAC list practices and their financial effects on insurers, PBMs, pharmacies, and providers.
- If the commission recommends changes, it could lead to legislation to standardize MAC list development and enhance transparency.
- Stakeholder representation aims to balance payer, provider, pharmacy, and pharmaceutical industry perspectives in any recommendations.
Context
- A similar measure was filed in a prior session (House No. 1056, 2023-2024), indicating ongoing legislative interest in MAC list governance.
- No funding or staffing details are specified in the bill beyond the 10-member commission.
Compiled from official sources — confirm details with the bill’s official record.
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