State health regulators may soon have greater oversight and enforcement powers over private equity investors, as lawmakers seek to avoid another crisis like the Steward Healthcare bankruptcy in Massachusetts.
Bay State legislators who take prescription drugs for chronic conditions such as diabetes are also poised to receive financial relief under two key late-session agreements unveiled in closed-door discussions Friday night.
The last breakthrough of the session, the two health care bills had been in negotiations for four months as House and Senate negotiators tried to trade policy between the House’s deep-seated hospital oversight bill and the Senate’s enacted prescription drug bill. It continued to tangle. Many years are coming.
The Senate is scheduled to consider the bill on Monday, according to the branch’s agenda. The House accepted the hospital oversight bill within minutes of its introduction on Monday.
The two-year parliament adjourns on Tuesday and a new parliament must be sworn in on Wednesday.
The Medical Oversight Agreement (H 5159) imposes harsher penalties on hospitals that fail to comply with reporting requirements, requires lessors to notify the state 60 days before collecting medical equipment, and requires the state to notify the state 60 days before collecting medical equipment It prevents hospitals from issuing and maintaining licenses. I borrow from a real estate investment trust. These provisions were primarily inspired by the stewardship crisis.
The agreement also requires private equity investors, real estate investment trusts, and managed services organizations to comply with financial reporting requirements to the Center for Health Information Analysis. Fines for failing to submit data on time will jump from $1,000 to $25,000 per week, with no cap.
Attorney General Andrea Campbell will also gain tools to hold private equity firms accountable, including increased investigative powers into health care deals.
Negotiators released resolutions from two conference committees Friday night. Under the Pharmaceutical Reform Agreement (S 2520), patients will pay less than $25 for certain name brand drugs to treat chronic diseases, including insulin for diabetes, and less for similar generic drug options. It will cost you nothing.
The bill would also require MassHealth, group health boards covering state employees, retirees, and their dependents, and other insurance companies to purchase one generic drug and one name-brand drug for each of diabetes, asthma, and asthma. It is mandatory to compensate for one. The two most common heart diseases.
Language that reduces or eliminates cost burdens for people with chronic conditions was a priority for Senate President Spilka. The Senate passed the bill in November 2023, and the House approved it in late July 2024.
The bill also creates a licensing process for pharmacy benefit managers. PBMs broker drug deals between insurers, manufacturers and pharmacies, and supporters say their work lowers costs for consumers. Critics say PBMs operate with little oversight, contributing to rising costs.
The bill directs the Department of Insurance to license and regulate PBMs operating in Massachusetts. PBMs would also be prohibited from making payments to pharmacy benefits consultants or brokers if this constitutes a conflict of interest.
