Healthcare

in committee · Massachusetts · House Jul 31, 2026

H 4893: An Act to support behavioral health prevention for children

H 4893 requires health insurance plans in Massachusetts to cover at least six sessions of preventive behavioral health services for individuals under 21 who have a positive screening for depression, anxiety, or other emotional concerns (or for infants whose caregivers screen positive for postpartum depression), without cost-sharing or prior authorization. This applies to group insurance plans for state employees, private insurance policies, and health plans governed by state law, covering individual, family, or group sessions delivered in pediatric primary care, community, or school settings. Insurers must accept alternative diagnosis codes (like Social Determinants of Health Z-codes) for billing these services. The bill directly affects children, adolescents, and infants with early behavioral health screenings by mandating accessible, no-cost preventive care to help prevent more severe conditions.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for preventive behavioral health services without cost-sharing for minors, expanding access to mental health care as required by the bill.95% confidence

Sub-Topics Children's Health Insurance Mental Health

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in committee · Massachusetts · House Jul 27, 2026

H 4958: An Act relative to opioid use disorder treatment and rehabilitation coverage

This bill (H 4958) requires all health insurance plans in Massachusetts - covering Commonwealth employees, Medicaid recipients, and private insurance policies - to provide full coverage for medications treating opioid use disorder, including opioid antagonists and agonists (like methadone or buprenorphine). It eliminates prior authorization requirements and removes all out-of-pocket costs (deductibles, copays, coinsurance) for these medications, treating them as medically necessary. The coverage applies whether the medication is dispensed by a pharmacy or administered at a treatment facility, with facilities reimbursed at standard rates to prevent balance billing. This directly affects patients seeking opioid use disorder treatment and the insurers/health plans providing their coverage.

Topics ✓ HealthcareSupports HealthcareMandates full insurance coverage for opioid treatment medications without cost-sharing or prior authorization, eliminating access barriers and treating as medically necessary.95% confidence

Sub-Topics Insurance Medicaid Substance Abuse

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in committee · Massachusetts · House Jul 30, 2026

H 4895: An Act expanding access to mental health services

H 4895 removes preauthorization requirements for insured patients seeking specific mental health services, including inpatient psychiatric care, crisis stabilization, substance use disorder treatment, and community-based acute care. It directly affects Commonwealth employees with group insurance and Medicaid recipients by ensuring coverage for these services without prior insurer approval. Key provisions require facilities to notify insurers within 3 business days of admission (limited to basic patient and treatment details) while guaranteeing coverage for services provided before notification. The bill also expands the definition of "licensed mental health professional" to include more provider types, such as licensed clinical social workers and master's-level clinicians under supervision. These changes aim to streamline access to critical mental health care by reducing administrative barriers.

Topics ✓ HealthcareSupports HealthcareRemoves preauthorization barriers for mental health services, ensuring coverage without prior insurer approval for critical care, directly expanding patient access to mental health treatment.95% confidence

Sub-Topics Healthcare Workforce Insurance Mental Health

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in committee · Massachusetts · House Apr 15, 2026

H 4898: An Act relative to dual diagnosis treatment coverage

This bill (H 4898) requires Massachusetts health insurers and Medicaid to cover specific addiction and mental health treatment services without preauthorization. It defines three key services: "acute treatment" (24-hour medically supervised addiction care), "clinical stabilization" (post-detox recovery support), and "co-occurring treatment" (inpatient psychiatric care for dual diagnosis). The law mandates coverage for up to 14 days for clinical stabilization and co-occurring services, with facilities required to notify insurers within 48 hours of admission. It directly affects Commonwealth employees (via Group Insurance Commission), Medicaid beneficiaries, and private insurers offering hospital/surgical coverage in Massachusetts. Medical necessity is determined by clinicians, not insurers, streamlining access to critical early recovery care.

Topics ✓ HealthcareSupports HealthcareMandates insurer/Medicaid coverage of addiction/mental health services without preauthorization, expanding access and protecting patient rights for dual diagnosis treatment.95% confidence

Sub-Topics Hospitals Mental Health Substance Abuse

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passed · Massachusetts · Senate Jun 15, 2026

S 2928: An Act to establish a celiac disease screening pilot program

By Ms. Lovely, a petition (accompanied by bill, Senate, No. 2928) (subject to Joint Rule 12) of Joan B. Lovely and Michelle L. Badger for legislation to establish a celiac disease screening pilot program. Public Health.

Topics ✓ HealthcareSupports HealthcareEstablishes celiac disease screening pilot program under public health, advancing preventive healthcare access and services.90% confidence

Sub-Topics Public Health

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in committee · Massachusetts · House Aug 10, 2026

H 4953: An Act promoting consumer choice in health care

This bill requires health insurance companies to reimburse licensed athletic trainers (with physician referrals) for services they're legally allowed to provide, on the same terms as other covered providers. It applies only to health plans that already cover similar services or conditions within athletic trainers' scope of practice. Insurers cannot impose additional cost-sharing (like higher deductibles) or utilization restrictions that unfairly target athletic trainer care, though standard plan rules still apply. The law ensures athletic trainers are treated equally for covered services without expanding their scope of practice.

Topics ✓ HealthcareSupports HealthcareMandates equal insurance reimbursement for athletic trainers, expanding access to covered services without additional costs or restrictions.95% confidence

Sub-Topics Healthcare Workforce Insurance Medical Licensing

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introduced · Massachusetts · House Jan 15, 2026

HD 5516: A communication from the Executive Office of Health and Human Services (see item 4000-0601 of Section 2 of Chapter 9 of the Acts of 2025) submitting the transfer certification to the Medicare Savings program from the prescription advantage program and the Health Safety Net Trust Fund for fiscal year 2024

This is a procedural report, not a legislative bill. It details the required submission to the Legislature about funding transfers supporting Massachusetts' Medicare Savings Program for fiscal year 2024. The report confirms $7.7 million was transferred from the Health Safety Net Trust Fund (and $0 from the Prescription Advantage Program) to cover Medicare cost-sharing for seniors and disabled residents enrolled in the program. It also provides enrollment data showing over 292,000 seniors/discharged individuals were covered under the program during the reporting period.

Topics ✓ HealthcareSupports HealthcareConfirms $7.7M transfer from Health Safety Net Fund to Medicare Savings Program, funding cost-sharing for 292k+ seniors/disabled residents.85% confidence

Sub-Topics Medicare

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in committee · Massachusetts · House Jul 27, 2026

H 4951: An Act to address barriers to HIV prevention medication

This bill (H 4951) requires Massachusetts health insurance plans and state employee health coverage to fully cover HIV prevention medications (like PrEP) without cost-sharing (no copays, deductibles) or prior approval delays. It applies to state employees, retirees, and all health insurance policies (individual and group) covering hospital/surgical expenses. Key provisions mandate that insurers cannot deny coverage based on the type of healthcare provider prescribing the medication or where it's prescribed (e.g., clinic vs. hospital), as long as the provider is licensed. The law also ensures coverage includes necessary monitoring services like lab tests and counseling, as defined by federal health agencies.

Topics ✓ HealthcareSupports HealthcareMandates full insurance coverage for HIV prevention meds (PrEP) without copays/deductibles, removing financial barriers to access.95% confidence

Sub-Topics Hospitals Insurance Primary Care

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in committee · Massachusetts · House Jan 7, 2026

H 4880: An Act regarding Title XIX reimbursements for state colleges and universities

This bill directs Massachusetts' Executive Office of Health and Human Services to form a working group to study how state colleges and universities can claim federal Medicaid funds (Title XIX) for health services provided to students covered by MassHealth. It specifically examines opportunities for students of all ages, including those with disabilities and those eligible for both Medicaid and Medicare, as well as administrative and programmatic approaches to claiming these funds. The working group must produce a report by April 2027, including financial estimates of potential revenue, challenges, and a preliminary plan for pursuing these funds. The bill does not change current law but initiates a study to explore potential new revenue streams for public colleges.

Topics ✓ HealthcareSupports HealthcareBill establishes working group to study Medicaid reimbursement for student health services, aiming to expand MassHealth coverage access for students including disabled and dual-eligible individuals.85% confidence

Sub-Topics Medicaid Medicare

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in committee · Massachusetts · House Jul 29, 2026

H 4941: An Act relative to health savings accounts

This bill amends state law to align with federal requirements for health savings account (HSA)-qualified health insurance plans. It exempts these specific plans from state rules prohibiting cost-sharing (like copays or deductibles) for covered benefits, as long as the exemption is necessary to meet federal HSA criteria. However, the exemption does not apply to preventive care services covered under federal guidance. The bill directly affects insurers offering HSA-qualified plans and consumers enrolled in such plans, ensuring state regulations don't conflict with federal HSA eligibility rules.

Topics ✓ HealthcareSupports HealthcareExempts HSA-qualified plans from state cost-sharing rules to align with federal requirements, facilitating availability of these healthcare insurance options.95% confidence

Sub-Topics Insurance Primary Care

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