Healthcare

passed · Massachusetts · House Jan 8, 2026

H 1135: An Act for supportive care for serious mental illness

By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 1135) of Marjorie C. Decker relative to healthcare insurance coverage for supportive care for serious mental illness. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill mandates healthcare insurance coverage for supportive care in serious mental illness, expanding access to mental health services.95% confidence

Sub-Topics Mental Health

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passed · Massachusetts · House Dec 4, 2025

H 1399: An Act relative to an individual Medicare marketplace option

This bill (HD 3446) allows eligible retired state employees and their Medicare-eligible dependents to enroll in health insurance plans purchased through the individual Medicare marketplace. It requires health reimbursement arrangements (HRAs) for these retirees to cover the costs of the lowest-cost Medicare Supplement Plan 1 and Part D prescription drug coverage in Massachusetts. The bill mandates that HRAs provide minimum annual funding equal to 50% of the sum of these two costs (based on annual rates set by the state). This change directly affects retired state employees and their Medicare-eligible family members who previously had limited options for supplemental coverage.

Topics ✓ HealthcareSupports HealthcareCreates individual Medicare marketplace option, expanding coverage choices for beneficiaries under Health Care Financing.95% confidence

Sub-Topics Medicare

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passed · Massachusetts · Senate Dec 4, 2025

S 310: An Act relative to mental health education

This bill (S 310) proposes requiring public schools to incorporate mental health education into their curricula. It directly affects school systems and students by mandating the inclusion of age-appropriate mental health topics. The key provision is a requirement for schools to develop and implement mental health education programs, though specific content details are not outlined in the abstract. The bill aims to address mental health awareness and education at the foundational level in schools.

Topics ✓ EducationSupports EducationMandates mental health education in K-12 curricula, enhancing student well-being programs per bill's requirement95% confidence ✓ HealthcareSupports HealthcareMandates mental health education in schools, directly supporting mental health awareness and prevention as part of healthcare policy.95% confidence

Sub-Topics Student Health Mental Health

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passed · Massachusetts · House Sep 18, 2025

H 1296: An Act to protect 340B providers

H 1296, titled "An Act to protect 340B providers," is a bill introduced by Representative Sean Reid to support healthcare providers participating in the federal 340B drug pricing program, which allows safety-net providers to purchase medications at discounted rates. The abstract does not specify the bill's exact mechanisms or provisions, only stating it aims to protect these providers. It falls under the Financial Services committee, suggesting a focus on financial or operational safeguards. Without additional details from the full bill text, the specific policy changes or direct effects on providers cannot be described.

Topics ✓ HealthcareSupports HealthcareBill protects 340B providers, ensuring safety-net healthcare facilities maintain discounted drug access for patients, directly strengthening healthcare affordability and access.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · House Sep 18, 2025

H 1364: An Act relative to promoting healthcare access and affordability for patients

This bill requires health insurers and pharmacy benefit managers to pass at least 80% of estimated drug rebates directly to patients by reducing their out-of-pocket costs at the pharmacy, rather than keeping the savings. Insurers must report compliance annually to the state commissioner, with potential fines for non-compliance, while protecting rebate details as confidential business information. Additionally, it mandates a state analysis of barriers to accessing cell and gene therapies for MassHealth patients, including projected costs, reimbursement frameworks, and infrastructure needs through 2037, with specific focus on impacts on vulnerable populations.

Topics ✓ HealthcareSupports HealthcareBill explicitly promotes healthcare access and affordability, directly aligning with support indicators like improving patient access and funding initiatives.95% confidence

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in committee · Massachusetts · House Dec 4, 2025

H 4491: An Act relative to non-medical switching

This bill prevents health insurers from forcing patients to switch prescription drugs without medical necessity ("nonmedical switching"). It requires insurers to maintain coverage for drugs a patient is medically stable on (as determined by their doctor), unless the drug is removed due to FDA safety concerns or manufacturing issues. Insurers must provide a clear, fast-track process for patients to request coverage exemptions, responding within 72 hours (24 hours for emergencies), with automatic approval if they miss deadlines. The bill directly affects patients on stable prescription regimens and health insurers managing drug coverage under health benefit plans.

Topics ✓ HealthcareSupports HealthcarePrevents insurers from forcing unnecessary drug switches, requires coverage maintenance for stable patients, and mandates fast-track exemptions, protecting patient access and rights in prescription coverage.95% confidence

Sub-Topics Prescription Drugs

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in committee · Massachusetts · House Jun 17, 2026

H 4492: An Act relative to patient financial protection

This bill requires health insurance plans in Massachusetts covering prescription drugs to establish a separate out-of-pocket limit for those drugs - including specialty drugs - distinct from other medical costs. The limit cannot exceed the federal minimum annual deductible for high-deductible health plans (set under IRS code 26 U.S.C. §223), which covers both self-only and family coverage. It defines "out-of-pocket limit" to include cost-sharing expenses like copays under the Affordable Care Act. The rule applies to all relevant health insurance policies renewed or issued on or after January 1, 2026, directly affecting insurers and patients with prescription drug coverage.

Topics ✓ HealthcareSupports HealthcareRequires separate out-of-pocket limits for prescription drugs, capping patient costs to prevent excessive financial burden, aligning with patient protection in healthcare.95% confidence

Sub-Topics Prescription Drugs

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in committee · Massachusetts · House Aug 4, 2026

H 4493: An Act to ensure access to prescription medication and community pharmacies

This bill requires pharmacy benefit managers (insurance companies that manage drug benefits) to pay community pharmacies fairly for services, matching or exceeding Massachusetts Medicaid rates for both drug costs and dispensing fees. It prohibits "pharmacy steering" (directing prescriptions to pharmacies owned by the benefit manager) and mandates that all pharmacies, including community ones, can provide specialty medications if they meet standard service requirements. The bill also requires transparency in how drug costs are calculated and gives pharmacies a 7-day process to appeal underpayment claims. It directly affects community pharmacies, benefit managers, and patients seeking medication access, aiming to ensure equitable treatment for independent pharmacies.

Topics ✓ HealthcareSupports HealthcareRequires fair PBM payments to community pharmacies, prohibits steering, and ensures specialty medication access - improving patient access to prescriptions and protecting community pharmacy viability.95% confidence

Sub-Topics Prescription Drugs

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in committee · Massachusetts · House Jun 17, 2026

H 4494: An Act prohibiting PBMs from discriminating against hospitals and patients participating in the 340B drug discount program

This bill prohibits pharmacy benefit managers (PBMs) from discriminating against hospitals and clinics participating in the federal 340B drug discount program. It specifically bans PBMs from paying lower rates for 340B drugs than non-340B drugs, charging extra fees for 340B participation, restricting network access based on 340B status, or imposing higher patient costs (like extra copays) when using 340B providers. The law directly affects safety-net hospitals, clinics, and their patients who rely on the 340B program to access discounted medications. It ensures these providers aren’t penalized for participating in the federal program through PBM billing practices.

Topics ✓ HealthcareSupports HealthcareProhibits PBMs from discriminating against 340B hospitals/patients, preventing higher copays and ensuring lower drug costs for safety-net providers, directly improving access to affordable care.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · Senate Mar 12, 2026

S 1563: An Act prioritizing patient access to care

By Ms. Kennedy, a petition (accompanied by bill, Senate, No. 1563) of Robyn K. Kennedy, Rebecca L. Rausch, Joanne M. Comerford, Susannah M. Whipps and other members of the General Court for legislation to prioritize patient access to care based upon the professional judgment of the physician.. Public Health.

Topics ✓ HealthcareSupports HealthcareBill prioritizes patient access to care based on physician judgment, directly improving healthcare access per support indicators.95% confidence

Sub-Topics Public Health

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