The proposed bill seeks to regulate non-medical switching practices by health carriers concerning prescription drug coverage. It introduces a new section to Chapter 175 of the General Laws, defining "nonmedical switching" as changes in a health benefit plan's formulary that require a covered person to switch to a less expensive drug despite being medically stable on their current prescription. The bill prohibits health carriers from limiting or excluding coverage for a prescription drug if the covered person is medically stable, has been prescribed the drug within the last six months, and remains enrolled in the health benefit plan. Coverage for such drugs must continue until the end of the covered person's eligibility under the plan, including during open enrollment periods.

Additionally, the bill establishes a process for requesting coverage exemption determinations, requiring health carriers to respond within specified timeframes and allowing for appeals of denied requests. If a coverage exemption is granted, the health carrier must provide coverage that is no more restrictive than what was previously offered. The bill emphasizes the importance of continuity of care and includes provisions for enforcement by the commissioner of insurance. These regulations will apply to health benefit plans delivered or renewed after January 1, 2026, aiming to protect covered individuals from arbitrary changes in their prescription drug coverage.