Legislative Updates

The Legislature today passed the FY25 State Budget. Included in the budget is the Fertility Preservation language that was originally the free standing bill, S.598, which MSCO has strongly supported. Both the House and Senate in their separate budget bills had included the language. Now the language is before the governor for her approval, which is expected.

A copy of the language is attached here. This language covers commercial insurers. Similar language is in the bill covering all other state regulated health insurance such as BCBS, HMOs, etc. 

Today, we join forces with other organizations in urging Massachusetts legislators to reform Pharmacy Benefit Managers (PBMs). PBMs often keep rebates intended for patients and favor more expensive drugs, driving up costs. With PBMs controlling nearly 80% of the market, it’s crucial to address their practices that often increase patient costs and limit access to essential medications. Our aim is to promote transparency, support community pharmacies, and prioritize patient care. 

Read the full letter and join us in advocating for meaningful change.

We are pleased to announce that MSCO has taken a proactive stance in supporting the Biomarker Bill, which has recently made significant progress in the legislative process.

Key points:

1. The bill was favorably reported out of the Health Care Financing Committee last week.

2. It is currently under review by the House Ways & Means Committee.

3. Our team has sent a letter of support for the bill to Representative Aaron Michlewitz, Chair of the House Ways & Means Committee.

We believe this bill has the potential to positively impact oncology in Massachusetts. We will keep you updated on any further developments.

If you have any questions or would like more information, please don't hesitate to reach out.

We thrilled to let you know that last night the Massachusetts Senate passed the language of our fertility preservation bill as a budget amendment on a 40-0 roll call vote (as it should be!). This is the same language that also passed as a House budget amendment, so this will become law when the final budget is approved. All the individuals and organizations who have supported this legislation know this will lead to much wanted future families after medical struggles so today we celebrate!  

For the first time, April has officially been designated as National Cancer Prevention and Early Detection Month! We had over 80 organizations sign our letter of support of this effort. We are so grateful for each of you for your support! The Prevent Cancer Foundation is proud to have led this effort to spread the word that Early Detection = Better Outcomes. 

Below are a few resources related to this announcement. Please share with your networks far and wide! 

·        Official White House Announcement 

·        Prevent Cancer Foundation Press Release 

·        National Cancer Prevention and Early Detection Month website 

·        Partner Toolkit 

On March 7, the Massachusetts Joint Committee on Financial Services advanced bills that would ban copay accumulators and expand coverage for fertility preservation services for cancer patients. The Massachusetts Society of Clinical Oncology (MSCO) and the Association for Clinical Oncology (ASCO) sent joint letters of support ahead of hearings for both the copay accumulator and fertility preservation bills. Both bills were carried over from 2023 and have been referred to the Joint Committee on Health Care Financing. 

MOPSS Champions Vital Dental Bill H1094 for Cancer Survivors

Boston, MA – In a significant stride toward improving access to dental care for head and neck cancer survivors, Massachusetts Oncology Patients, Survivors, and Supporters (MOPSS) is thrilled to announce that House Bill 1094 (H1094) has been referred to the Joint Committee on Health Care Financing from the Joint Committee on Financial Services.

H1094, titled "An Act expanding coverage of dental procedures," aims to mandate insurers in Massachusetts to cover medically related dental treatment. The bill is a crucial step in addressing the unique challenges faced by head and neck cancer survivors, who often contend with oral health issues resulting from cancer treatments.

"We are excited about the progress of H1094 and grateful for the opportunity to present our case to the Joint Committee on Health Care Financing," said Thomas Healy, Founder of MOPSS. "This bill has the potential to make a profound impact on the lives of head and neck cancer survivors, ensuring they receive the necessary dental care to enhance their overall well-being."

The Joint Committee on Health Care Financing will play a pivotal role in reviewing and considering the merits of H1094. MOPSS looks forward to actively engaging with the committee and advocating for the bill's passage.

The bill, which has gained support from various quarters, addresses survivors' financial challenges due to the lack of insurance coverage for necessary dental procedures. MOPSS has been actively rallying for the inclusion of dental care, recognizing the interdependence of oral health and overall well-being, especially concerning medically related dental treatment.

MOPSS and all head and neck cancer survivors sincerely thank the Joint Committee on Financial Services for supporting House Bill 1094. In this pivotal moment, the collaboration between advocacy groups and legislative bodies represents a significant stride toward coverage for dental procedures, offering relief to survivors and enhancing their quality of life.

Massachusetts Oncology Patients, Survivors, and Supporters (MOPSS)

House Bill 1094 (H1094) - An Act to expand dental care coverage

MOPSS (www.mopss.org)

Committee in Massachusetts advanced legislation this week that would ban copay accumulator programs in the state. The Association for Clinical Oncology (ASCO) submitted a joint letter of support ahead of these hearings with the Massachusetts Society of Clinical Oncology. The bill is now referred to the committee on Financial Services.

Last week, we saw the House Oversight Committee pass the House DRUG Bill (H.R. 6283). This bipartisan legislation would:

• Ban PBMs from charging fees based on a drug's list price, instead allowing PBMs to charge a flat fee for service; 
• Ban spread pricing, in which PBMs charge insurers more than they pay pharmacies; and
• Prohibit PBMs from steering patients to affiliated pharmacies.

Congressman Lynch also spoke on an amendment that would increase transparency and oversight of PBM practices. 

Continue this momentum and see meaningful PBM reform included in the March 8th CR package. Contact Senator Markey's and Representative Trahan's offices via email or social media to encourage their support for Senate Bill 1542 and H.R. 6283.

Step therapy is defined as a “utilization management policy or program that establishes the specific sequence in which a prescription drug for a specified medical condition is covered by a carrier.”  This bulletin applies to fully insured Massachusetts licensed carriers that provide coverage for prescription drugs and outlines the process to request an exception to step therapy protocols. Exceptions may be requested when the drug required under the step therapy protocol is contraindicated, expected to be ineffective, has previously been tried and was ineffective and thus discontinued, or the patient is stable on a prescription drug prescribed by their provider and switching drugs will likely cause an adverse reaction. The exception request must be acted on not more than 3 business days following the receipt of all information or within 24 hours for urgent situations.  Carriers are expected to forward implementation plans to the DOI by February 15th.