Bill
H 4490
Prohibits payers, manufacturers, and distributors from discriminating against 340B entities and contract pharmacies, protecting patient choice and access to 340B drugs.
Status and procedural history
- Introduced in the Massachusetts House: September 18, 2025.
- Reported favorably by the House Committee on Financial Services on September 18, 2025 and referred to the Committee on Health Care Financing.
- Committee report (James M. Murphy) recommended passage.
- Note: the file also contains a separate South Carolina House resolution (May 6, 2025) expressing sympathy on the death of Jack David Plating; that resolution is unrelated to the Massachusetts legislation.
Purpose / intent
- To prohibit discriminatory treatment of entities and pharmacies participating in the federal 340B Drug Pricing Program (340B) by payers (insurers), drug manufacturers, and distributors, and to protect patient choice to receive 340B-purchased drugs.
Key definitions (selected)
- “340B-covered entity” / “340B grantee”: as defined in the federal statute, 42 U.S.C. §256b(a)(4).
- “Contract pharmacy”: a pharmacy that dispenses 340B drugs under contract with a 340B-covered entity.
- “340B drug”: a drug offered at reduced price under 42 U.S.C. §256b.
- “Drug coverage”: insurers or plans that reimburse for outpatient drugs (excluding amounts paid directly by individuals).
Major substantive provisions
1. Prohibitions on payers (added to G.L. c. 32A, new §35):
- Insurers/drug payers may not reimburse a 340B-covered entity or its contract pharmacy at a lower rate or impose different reimbursement terms because the entity is a 340B participant or dispenses 340B drugs.
- Payers may not impose discriminatory requirements, exclusions, fees, clawbacks, chargebacks, adjustments, or differing audit/inventory management practices on 340B entities or contract pharmacies relative to similarly situated non-340B entities.
- Payers may not require claim modifiers or other identifiers that mark a claim as a 340B drug (except where Medicaid rules require such identification).
- Payers must not steer, prevent, or otherwise interfere with a patient’s choice to receive 340B drugs from a 340B-covered entity or its contract pharmacy.
Enforcement and remedies
- Violations of the manufacturer/distributor prohibitions are treated as unfair or deceptive acts under G.L. c. 93A; each package subject to a prohibited act constitutes a separate violation.
- The Attorney General is given enforcement jurisdiction consistent with chapter 93A (text in the document indicates AG enforcement authority; the bill text is truncated but establishes AG civil enforcement).
Who is affected
- 340B-covered entities (safety-net providers, certain hospitals, federally qualified health centers) and their contract pharmacies.
- Pharmacies that participate as contract pharmacies.
- Health insurers, pharmacy benefit managers, and other payers providing outpatient drug coverage in Massachusetts.
- Drug manufacturers and distributors selling drugs in the Commonwealth.
- Patients eligible to receive 340B-purchased drugs.
Potential impacts and considerations
- Seeks to preserve access to discounted 340B drugs and to limit payer and manufacturer practices that could undermine 340B program benefits.
- Could constrain payer network design, reimbursement policies, contract provisions with pharmacies, and manufacturer distribution practices.
- Creates state-level enforcement via chapter 93A; possible litigation risk if parties dispute scope or conflict with federal law or HHS guidance.
- The bill includes several specific operational limits (e.g., bans on claim modifiers), but also exempts practices explicitly required by federal Medicaid/HHS rules.
Notes
- The bill references federal 340B law (42 U.S.C. §256b) and incorporates the federal definition of covered entities; applicability may depend on federal program rules and any HHS guidance or restrictions.
- The included South Carolina House “Jack Plating” resolution in the text is unrelated to the Massachusetts bill and appears to be an extraneous document appended to the file.
Compiled from official sources — confirm details with the bill’s official record.
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