Massachusetts H4491 aims to prevent non-medical switching of prescription drugs in health benefit plans.
Massachusetts H4491 addresses non-medical switching in health benefit plans, which involves changes that force a person to switch to a less costly drug. The bill prohibits health carriers, health benefit plans, and utilization review organizations from limiting or excluding coverage of a prescription drug for a person who is medically stable on their current drug. It also mandates a clear process for requesting coverage exemptions and requires timely responses to such requests. If a request is denied, it can be appealed.
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