{"data":{"id":"us-ma/mass.-gen.-laws-ch.-94c-21c","jurisdiction":"us-ma","citation":"Mass. Gen. Laws ch. 94C, § 21C","heading":"Point of sale charge for prescription drug; limit on amount of cost-sharing payment","body":"Section 21C. (a) For the purposes of this section, the following words shall have the following meanings unless the context clearly requires otherwise:\n''Cost-sharing'', an amount owed by an individual under the terms of the individual's health benefit plan.\n''Health benefit plan'', as defined in section 1 of chapter 176O.\n''Pharmacy benefit manager'', as defined in section 1 of chapter 176Y.\n''Pharmacy retail price'', the amount an individual would pay for a prescription drug at a pharmacy if the individual purchased that prescription drug at that pharmacy without using a health benefit plan or any other prescription medication benefit or discount.\n(b) At the point of sale, a pharmacy shall charge an individual for a prescription drug the lesser of: (i) the applicable cost-sharing amount; or (ii) the pharmacy retail price.\n(c) A health benefit plan or carrier shall not require an insured to make a cost-sharing payment for a prescription drug in an amount greater than that charged pursuant to subsection (b).\n(d) No contractual obligation between a pharmacy benefit manager and a pharmacist shall prohibit a pharmacist from complying with this section.","path":["Part I","Title XV","Chapter 94C"],"source_url":"https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXV/Chapter94C/Section21C","current_through":"amendments passed before May 31, 2026","vintage":"","retrieved_at":"2026-09-17T05:22:11Z","sha256":"b56284f5be1dbfbc828f52999dfa342d66446a00e0fcdc530b6c2cee01901c63","source_id":"us-ma","stale":false,"prev":"us-ma/mass.-gen.-laws-ch.-94c-21b","next":"us-ma/mass.-gen.-laws-ch.-94c-22"},"notice":"GroundRules: Original legal text. Not legal advice."}