This bill (H 4899) requires health insurance plans in Massachusetts to cover post-pregnancy mental health care - including postpartum and post-miscarriage care - without any out-of-pocket costs like deductibles or copays. It applies to both private insurance and Medicaid plans, ensuring coverage is equally available to enrollees and their spouses or dependents. The law explicitly adds this care to existing pregnancy-related coverage requirements in multiple sections of state health laws and prohibits unreasonable delays or restrictions in accessing these services.
H 4897 requires most health insurance plans in Massachusetts to cover "behavioral health bundled services" from licensed community behavioral health centers on equal terms. This applies to group insurance for Commonwealth employees (active and retired), individual accident/sickness policies, hospital service plans, and health maintenance contracts. The bill mandates that these plans provide nondiscriminatory coverage for medically necessary mental health, developmental, or substance use disorder care delivered through defined community centers. It directly affects insured individuals and insurers by standardizing coverage requirements across multiple insurance types. The law applies to policies issued or renewed within or outside Massachusetts.
H 4935 requires health insurance plans and medical assistance programs in Massachusetts to cover prevention, diagnosis, and treatment of diseases designated by the commissioner as "of heightened public health importance" without cost-sharing (like copays or deductibles) or prior authorization. It applies to all health coverage under specific Massachusetts laws, including group insurance (Chapter 32A), Medicaid (Chapter 118E), and individual hospital/surgical plans (Chapters 175, 176A, 176B, 176G). The commissioner must publicly list designated diseases, review the list annually, and notify insurers and providers. An exception allows cost-sharing for tax-exempt plans that would lose their status if prohibited.
This bill (H 4934) requires Massachusetts Medicaid insurers to cover non-opioid pain medications equally with opioids - prohibiting restrictions like labeling them "non-preferred" or imposing stricter prior authorization. It mandates comprehensive care coordination for Medicaid members with chronic pain, including access to integrated services (primary care, specialists, physical therapy, mental health) and individualized treatment plans by 2027. The bill also directs the state to collect data on chronic pain incidence, demographics, treatment costs, and care gaps, publishing reports every two years starting in 2028. These provisions directly affect Massachusetts Medicaid enrollees with chronic pain and their healthcare providers.
H 4947 updates Massachusetts' process for reviewing health insurance mandates requiring coverage for specific treatments, services, or equipment. The bill requires the Center for Health Information and Analysis to analyze proposed mandates, assessing public health impacts (like disease prevention), medical effectiveness (using peer-reviewed research), financial effects (costs to insurers and consumers), and other factors. The Center must submit written reports within 180 days, including data on how mandates affect essential health benefits, premiums, and access to care. This directly affects health insurers, employers offering group coverage, and patients covered by Massachusetts health plans. The bill aims to ensure new mandates are evidence-based and financially sustainable before becoming law.
H 4949 renames the "Division of Insurance" to "Division of Health Insurance" and changes "Commissioner of Insurance" to "Commissioner of Health Insurance" across multiple state statutes. It reorganizes the Department of Banking, Insurance and Health Insurance by renaming the department and updating references to its divisions throughout the General Laws. This bill is procedural - it changes administrative titles and structures without creating new health insurance policies or regulations. The changes affect state departments and staff responsible for overseeing insurance markets, specifically clarifying that health insurance oversight falls under a dedicated division. The bill does not alter existing health insurance rules or consumer protections.
This bill (H 4938) requires health insurance plans to cover Technology-Assisted Tracking Devices for individuals diagnosed with dementia, Alzheimer's disease, or autism spectrum disorder. It defines these devices to be waterproof (IP66/IP68), indoor-compatible using Radio Frequency (not GPS), independent of cellular networks, tamper-resistant with caregiver-adjustable straps, and designed to prevent false alarms. The coverage must include the device subject to standard insurance cost-sharing like co-pays and deductibles. The bill directly affects insured individuals with these diagnoses and their caregivers by mandating insurance access to these safety devices.
This bill (H 4942) expands the definition of "licensed mental health professional" in five Massachusetts statutes to include licensed rehabilitation counselors. It directly affects rehabilitation counselors by recognizing them as qualified providers under existing laws governing insurance, healthcare services, and professional scope. The key mechanism adds "licensed rehabilitation counselor" to the list of covered professionals in sections related to mental health services, insurance coverage, and healthcare financing. This change aims to increase consumer access to rehabilitation counseling services by ensuring they are included in the same legal framework as other mental health professionals.
This bill requires health insurers with reserves exceeding 550% of risk-based capital to pay an assessment generating $400 million total. The funds are split equally: $200 million goes to the Health Safety Net Trust Fund (supporting community health programs) and $200 million to the Medicaid Stabilization Trust Fund (preventing access cuts for MassHealth beneficiaries). The assessment applies to insurers meeting specific reserve thresholds set by the Division of Insurance, with enforcement mechanisms including interest charges for late payments. The program expires on December 31, 2026.
H 4948 creates a dedicated Health Care Access Bureau within Massachusetts' Division of Insurance to strengthen oversight of health insurance rates. The bureau, led by a deputy commissioner, will review premium rates for all health insurance plans sold in Massachusetts, focusing on consumer affordability (including deductibles and out-of-pocket costs), fairness for providers, and alignment with state healthcare cost growth goals. It requires insurers to pay an annual assessment totaling $2 million to fund the bureau's operations, including hiring specialized staff like a chief health economist and chief actuary. The bill directly affects all health insurers licensed in Massachusetts by requiring them to submit rate data for review and pay new funding assessments.
This bill modifies Massachusetts health insurance regulations to make it easier for certain insurers to operate. It allows health insurance carriers to be exempt from specific network rules if they primarily serve members in single-rate regions, subsidized plans (like MassHealth), or rely heavily on government program income. Additionally, it requires insurers to include entire provider groups (not just parts of them) in network plans, either fully or not at all, and prevents restricting provider participation in tiered networks. These changes directly affect health insurance carriers operating in Massachusetts, aiming to simplify network requirements for some plans while expanding provider access. The bill focuses on procedural adjustments to existing coverage frameworks, not creating new subsidies or benefits.
This bill requires full-time firefighters in Massachusetts to receive regular neurological screenings every three years, starting three years after they begin employment. It applies to firefighters in city, town, and special fire departments (including military reservation and base departments like Devens). Screenings must cover specific neurological conditions like ALS, Alzheimer's, Parkinson's, and stroke, with all costs covered by the employer's health plan - no out-of-pocket expenses for firefighters. The law ensures access to these preventive check-ups without financial burden, except in rare cases where federal tax rules would be violated.
