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Physicians Tell Committee S.2732 Would Improve Access, Let Doctors Dispense Medications
Summary
Physicians and medical groups backed S.2732 to allow direct primary care (DPC) physicians to issue referrals for patients with HMO plans and to dispense medications in-office. They said the changes could reduce delays, improve continuity and lower out‑of‑pocket costs, especially in pharmacy‑scarce areas.
Dr. Jenny Labonte, who runs a direct primary care practice in Auburn, told the Joint Committee on Financial Services that S.2732 addresses two problems: HMOs blocking referrals from out‑of‑network primary care physicians and limits on physician in‑office dispensing. She said the 2023 CHIA health insurance survey shows wide primary‑care coverage but persistent access problems, and argued the bill would improve continuity and reduce delays to specialty care.
"Under the current laws, direct primary care physicians cannot issue an insurance referral for someone with an HMO plan," Dr. Labonte said, and added that in Maine similar reforms already exist.
Dr. Wendy Cohen emphasized the cost benefits of in‑office dispensing, listing wholesale prices for common generics (amlodipine 38¢/month, hydrochlorothiazide 27¢/month, fluoxetine 77¢/month, high‑dose atorvastatin $1.37/month) and estimating large annual savings for patients when doctors dispense low‑cost generics directly.
Dr. Reika Nair recounted cases in which HMO referral rules fragmented care and delayed needed testing; she described a patient who waited weeks for a cardiac scan authorization and similar long delays for a dermatology referral that left patients at risk and providers unpaid.
A representative of the Massachusetts GI Association (the transcript identifies him with the names 'Max Tilson'/'Max Hilton') said specialty practices also support the bill because in‑office dispensing helps ensure patients have necessary preparations and medications, particularly where local pharmacies have closed.
Witnesses asked the committee to advance S.2732 to remove administrative barriers, allow DPC physicians to be the referring PCP for HMO patients who choose DPC, and permit safe physician dispensing to improve adherence and affordability. No vote was taken on S.2732 at the hearing.
