SENATE, No. 1461

By Mr. Brown, a petition (accompanied by bill, Senate, No. 1461) of Scott P. Brown, Richard R. Tisei, Bruce E. Tarr, Michael R. Knapik and other members of the General Court for legislation to further regulate appeals under the Group Insurance Commission. Public Service.
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The Commonwealth of Massachusetts

Seal of the Commonwealth of Massachusetts

In the Year Two Thousand and Seven.

AN ACT further regulating appeals under the Group Insurance Commission

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 32A of the General Laws is hereby by amended inserting the following section:-

Section 17G. Any person, who is dispensed a non-formulary or non-preferred brand name prescription drug, as determined under a pharmaceutical drug program established by the commission or through a pharmacy benefit manager contracted by the commission, may appeal that determination to the commission; and upon the submission of a statement by the person’s physician that, due to a medical necessity, only the non-formulary, or non-preferred brand name prescription drug can be dispensed, the person shall pay for the drug at the same rate required for the formulary or preferred brand name prescription drugs under such pharmaceutical drug program.