In Review: The Health Coverage, Insurance, and Financial Services Committee (HCIFS) held a work session on a bill that required generics and biosimilars to be covered. After a lengthy discussion, the committee ultimately decided to change the bill from a mandate to a resolve for the Bureau of Insurance to do a data call to PBM pharmacy and therapeutic committee practices when building a formulary. A final report will be shared with the committee at the next legislative session. HCIFS also discussed a bill to establish coverage criteria for nonopioid, non-narcotic drugs that are more restrictive than the least restrictive coverage criteria for an opioid or narcotic drug. At the work session, language from Massachusetts was suggested as a strike-all amendment to require plans to offer non-drug options to treat pain. PCMA was able to review the language after the work session and determined that it no longer impacts PBMs. Next week, a follow-up work session is scheduled to review the strike-all amendment, and we anticipate the committee to vote ought to pass.

Up Next: HCIFS will meet on Wednesday, March 13, to review the nonopioid, non-narcotic amendment.

If you have any questions, please contact Sam Hallemeier at shallemeier@pcmanet.org.