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Bill

HD 3093

An Act to ensure access to prescription medication and community pharmacies

194th Legislature (2025-2026) Introduced by Carole Fiola and 1 co-sponsor

Massachusetts bill restricts pharmacy benefit managers' practices to protect community pharmacies' viability and guarantee patient access to local prescription medication services.

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Bill Summary · HD 3093

Legislative bill overview

HD 3093 would establish protections for community pharmacies and ensure patient access to prescription medications by restricting certain practices by pharmacy benefit managers (PBMs) and health insurers. The bill likely includes provisions preventing PBMs from steering patients away from independent pharmacies, limiting formulary restrictions that block medication access, and potentially establishing reimbursement rate floors for community pharmacies.

Why is this important

Community pharmacies have faced economic pressure from consolidation and PBM practices that favor large chains or mail-order operations, threatening their viability in many neighborhoods. Patients in rural and underserved areas particularly depend on local pharmacies for medication access, and closures reduce healthcare accessibility. The bill attempts to preserve this critical healthcare infrastructure while ensuring patients can fill prescriptions at their pharmacy of choice.

Potential points of contention

  • Cost implications: Restrictions on PBM practices and minimum reimbursement rates could increase insurance premiums or reduce PBM profitability, with unclear ultimate cost impact on consumers
  • Regulatory scope: Defining which PBM practices constitute anti-competitive behavior versus legitimate cost-management raises complex questions about federal vs. state authority
  • Implementation complexity: Creating enforceable standards around formulary decisions and reimbursement rates may be administratively challenging and could limit PBMs' ability to negotiate drug prices

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

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