Healthcare

introduced · Massachusetts · Senate

SD 98: An Act relative to pharmacists as healthcare providers

This bill allows pharmacists in Massachusetts to test for, screen, and initiate treatment for specific health conditions - including Influenza, Streptococcal infections, COVID-19, and HIV (including PrEP/PEP) - under a statewide protocol established by the Board of Pharmacy. It directly affects pharmacists (expanding their clinical role) and patients seeking accessible testing and initial treatment for these conditions. Key provisions require pharmacists to follow the protocol, delegate administrative tasks to technicians under supervision, and refer high-risk patients for hospital care when needed. The bill also mandates insurance companies to reimburse pharmacists for these services at standard rates for other healthcare providers, ensuring fair compensation.

Topics ✓ HealthcareSupports HealthcareExpands pharmacists' clinical role to provide testing/treatment for key conditions, improving patient access to care without restrictions.95% confidence

Sub-Topics Hospitals Prescription Drugs

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introduced · Massachusetts · House

HD 455: An Act relative to pharmacists as healthcare providers

This bill allows certified pharmacists in Massachusetts to test for, screen, and initiate treatment for specific health conditions - including influenza, strep infections, COVID-19, HIV (including PrEP/PEP), and others approved by the pharmacy board - under a statewide protocol. Pharmacists may delegate administrative tasks to pharmacy technicians and use CLIA-waived tests, with specific guidance for positive COVID-19 cases requiring patient advice and reporting. The law mandates that insurance companies reimburse pharmacists at standard rates for these services, prohibiting denial of coverage for certified pharmacists providing these treatments within their scope. It directly affects pharmacists, patients seeking these services, and healthcare insurers across the state.

Topics ✓ HealthcareSupports HealthcareExpands pharmacist scope to provide screenings/treatment for key conditions (influenza, HIV, etc.), mandates insurance coverage, improving access to healthcare services.95% confidence

Sub-Topics Prescription Drugs

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introduced · Massachusetts · House

HD 2578: An Act establishing a public health option

This bill establishes a public health insurance option in Massachusetts, creating a state-run plan available through the Commonwealth Connector. It will directly affect eligible individuals (residents not offered employer-sponsored coverage with 50+ employees) and small groups (1-50 employees) starting January 1, 2027, with large groups (51+ employees) added by July 1, 2027. The plan must meet the same quality and affordability standards as private plans approved by the Connector, use Medicare-based payment rates for providers, and cover all costs through premiums. It will operate alongside existing private plans but will be administered by the Connector, with providers automatically participating unless they opt out.

Topics ✓ HealthcareSupports HealthcareCreates state-run public health insurance option expanding coverage to eligible residents/small groups, meeting quality/affordability standards per Connector.95% confidence

Sub-Topics Insurance Medicare Public Health

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introduced · Massachusetts · House

HD 4253: An Act relative to ensuring health care options at institutions of higher education

This bill is a draft (currently being worked on by House Counsel) titled "An Act relative to ensuring health care options at institutions of higher education" filed by Rep. Lindsay Sabadosa on January 17, 2025. As a draft, it does not yet contain specific provisions or mechanisms detailing how health care options would be ensured. The bill would directly affect students and higher education institutions in Massachusetts if enacted. No concrete policy changes or key provisions are available in the provided context since the draft is incomplete.

Topics ✓ HealthcareSupports HealthcareBill title 'ensuring health care options at institutions of higher education' directly supports student access to health services, aligning with healthcare access indicators.85% confidence

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passed · Massachusetts · House May 2, 2025

H 1386: An Act to ensure uniform and transparent reporting of medical debt data

By Representative Mahoney of Worcester, a petition (accompanied by bill, House, No. 1386) of John J. Mahoney for legislation to establish an electronic system of public reporting for providers as a prerequisite condition for advancing overdue medical bills to debt collection agencies. Health Care Financing.

Topics ✓ HealthcareSupports HealthcareMandates transparent medical debt reporting to prevent unfair collection practices, protecting patient rights and improving healthcare financing transparency.85% confidence

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passed · Massachusetts · House May 2, 2025

H 1350: An Act to address medical debt through hospital financial assistance reform

This bill requires Massachusetts hospitals to establish clear financial assistance policies for low- and moderate-income patients. It sets income-based discounts: free care for households under 200% of the federal poverty level (FPL), 75% discounts for 201-300% FPL, 50% for 301-350% FPL, and 25% for 351-400% FPL. Hospitals must provide written and verbal notices about these policies during registration and billing, post notices prominently in facilities, and include clear financial assistance information on all billing statements. The bill also prohibits hospitals from considering immigration status, total bill cost, or restrictive contracts when determining eligibility, and mandates annual reporting of application data by hospital.

Topics ✓ HealthcareSupports HealthcareBill addresses medical debt via hospital financial assistance reform, improving patient access and reducing financial barriers to healthcare services.92% confidence

Sub-Topics Hospitals

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passed · Massachusetts · House May 22, 2025

H 1376: An Act relative to the operating budgets of health care oversight agencies

HD 637 limits annual increases in assessments paid by health care providers and manufacturers. It caps the total assessed amount for acute hospitals, ambulatory surgical centers, non-hospital providers, pharmaceutical companies, pharmacy benefit managers, and surcharge payors at no more than the annual health care cost growth benchmark approved by the health policy commission. This applies to both the Health Care Cost Containment Commission (Section 6) and the Health Policy Commission (Section 7). The bill directly affects these entities by restricting how much their mandatory assessments can rise each year.

Topics ✓ HealthcareSupports HealthcareBill addresses operating budgets for healthcare oversight agencies, indicating funding support for healthcare administration and oversight functions.90% confidence

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passed · Massachusetts · Senate Jan 29, 2026

S 905: An Act to improve health care cost accountability

This bill establishes a standardized metric called the "Weighted Average Payer Rate" (WAPR) to measure healthcare payment rates. WAPR calculates a single average payment rate for hospitals and physician organizations by combining revenue from Commercial, Medicare, and Medicaid payers, weighted by each payer's share of total patient revenue. The bill requires these providers to report their WAPR annually, and mandates public hearings to analyze how WAPR trends relate to overall healthcare cost growth in Massachusetts. This data will inform oversight of healthcare costs, reimbursement levels, and system efficiency without changing current payment structures.

Topics ✓ HealthcareSupports HealthcareBill improves healthcare cost accountability, enhancing financial management and efficiency in healthcare financing systems.85% confidence

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passed · Massachusetts · House Jul 9, 2026

H 1384: An Act updating the health care cost growth benchmark and associated market oversight activities

By Representative Lawn of Watertown, a petition (accompanied by bill, House, No. 1384) of John J. Lawn, Jr. relative to health care cost growth benchmark and associated market oversight activities. Health Care Financing.

Topics ✓ HealthcareSupports HealthcareBill updates health care cost growth benchmark and market oversight, aiming to manage costs and improve affordability, aligning with supporting health care access and reducing financial barriers.70% confidence

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passed · Massachusetts · Senate Jan 29, 2026

S 896: An Act to prohibit inappropriate use of the health care cost growth benchmark

This bill (SD 78) limits healthcare providers' ability to negotiate rate increases with insurance companies that exceed the state-established health care cost growth benchmark. It directly affects hospitals, clinics, and other healthcare providers when they seek higher payments from insurance carriers. The key provision adds a new requirement to existing law, prohibiting rate increases above the benchmark defined in Chapter 6D, Section 9 of the General Laws. This creates a concrete cap on negotiated payment increases for healthcare services.

Topics ✓ HealthcareSupports HealthcarePrevents misuse of healthcare cost benchmark that could restrict funding or services, protecting healthcare program integrity.85% confidence

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