This bill requires the state to cover health insurance premiums for qualifying adjunct faculty at public higher education institutions. It defines eligible faculty as those teaching at least two 3-credit courses per semester (or four annually), regardless of funding source or employment term. The state will gradually increase its share of premium costs over five years, starting at 25% in the first year and reaching 75% by the sixth year. A working group must study adjunct faculty retirement benefits, compensation, and career pathways, reporting findings by December 2026. The bill directly affects adjunct faculty at state universities, community colleges, and UMass campuses.
By Representative Badger of Plymouth, a petition (subject to Joint Rule 12) of Michelle L. Badger and Joan B. Lovely for legislation to establish a celiac disease screening pilot program for certain children. Public Health.
H 4939 requires health insurers and Medicaid plans to cover patient navigation services provided by certified community health workers. These services help patients access care by addressing chronic disease prevention, social needs screenings, health education, and overcoming barriers like language or health literacy. The bill mandates reimbursement for workers with national certification or approved training, effective January 1, 2026. It directly affects Medicaid-eligible patients and community health workers by expanding access to coordinated care support. The law also directs the Executive Office of Health and Human Services to secure federal funding for implementation.
This bill requires health insurers to cover all medical supplies for ostomy care (including management of surgically created or spontaneous fistulas) without forcing patients to use non-medical alternatives. It mandates that insurers transfer ostomy care records within 72 hours when patients switch coverage, ensures suppliers are reimbursed at Medicare rates, and extends prescriptions for these supplies to at least one year with no disruption in coverage. The law also requires suppliers to provide one month's advance notice before changing products, including samples for trial, and guarantees patients can return to their original product if substitutions compromise care. These provisions directly affect ostomy patients, healthcare providers, and insurers across Massachusetts.
This bill requires most health insurance plans in Massachusetts to cover hearing aids for insured residents. It mandates coverage for one hearing aid per hearing-impaired ear every 36 months, based on a physician's written statement of medical necessity, with coverage extending to the best-fit device (regardless of brand) and related services like fittings, adjustments, and repairs. The law caps patient copayments at $200 per hearing aid and prohibits higher deductibles or out-of-pocket costs than for other durable medical equipment. It applies to all group and individual health insurance policies, including non-group plans, ensuring consistent coverage for people with hearing loss.
H 4896 requires qualifying student health insurance plans to cover two specific mental health treatment programs: "Coordinated Specialty Care" for first-time psychosis (within 74 weeks) and "Assertive Community Treatment" for serious mental illness or emotional disturbance. It directly affects young people under 19 with serious emotional disturbance and adults 19+ with serious mental illness by mandating insurance coverage for these services without visit limits. Key provisions include requiring insurers to pay for these treatments through a bundled payment model (not per-service fees) and presuming medical necessity after a licensed professional's recommendation. The bill defines these terms to ensure consistent coverage under state insurance regulations.
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.
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 requires all health insurance plans in Massachusetts to cover biennial echocardiograms and concussion analysis for children aged 5 to 18. It applies to group coverage for state employees, standard health insurance policies, hospital service plans, medical service agreements, and health maintenance contracts. The coverage must be provided every two years at no additional cost to the patient. It directly affects insurers offering these plans and children in the specified age range.
