Prohibits payers, manufacturers, and distributors from discriminating against 340B entities and contract pharmacies, protecting patient choice and access to 340B drugs.

Requires insurers to allow medication sync with pro-rated copays and full dispensing fees; cannot deny partial fills for syncing; aims to boost adherence and lower costs.

Authorizes Arlington to use ranked-choice voting for specified local offices, pending voter approval; uses round-by-round tallies and publishes results to boost transparency.

Moves to curb PBMs in Massachusetts to expand pharmacy access by ensuring payment parity, banning steering and retroactive discounts, and mandating MAC transparency and updates.