Healthcare (Medicare)

introduced · Massachusetts · House

HD 577: An Act relative to stabilizing the Commonwealth’s nursing facilities

This bill adjusts how Massachusetts Medicaid pays nursing homes to stabilize funding. It requires annual inflation adjustments using the Medicare Market Basket Update, sets base costs to the most recent two-year period, and mandates a 10% above-average Nursing Cost Per Diem. Facilities serving 75%+ Medicaid residents receive a minimum 5% rate increase. Additionally, it preserves capital funding rates for facility upgrades completed after 2020. These changes directly affect nursing homes receiving Medicaid payments, aiming to better cover rising labor and care costs.

Topics ✓ HealthcareSupports HealthcareBill increases Medicaid nursing home payments via inflation adjustments, 10% cost per diem, and minimum 5% rate hikes for high-need facilities, directly strengthening healthcare funding stability.95% confidence

Sub-Topics Long-Term Care Medicare

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introduced · Massachusetts · House

HD 1839: An Act to provide fair and affordable public retiree benefits

This bill gradually increases retirement benefits for public employees by adjusting the percentage of Social Security benefits they receive, starting at 65% (replacing a fixed $18,000 amount) and rising to 100% over multiple years. It also prevents future health premium increases from affecting retirees who retired before such changes take effect, and caps out-of-pocket health costs at $2,500 for individual coverage and $5,000 for family coverage for retirees over 65 not eligible for Medicare. The changes take effect between 2025 and 2043, with specific provisions phasing in over time. The bill directly affects retired public employees in the state, particularly regarding their pension calculations and health insurance costs.

Topics ✓ Budget & TaxesSupports Budget & TaxesIncreases state spending on retiree benefits via adjusted Social Security percentages and health cost caps, funding essential public services.90% confidence ✓ HealthcareSupports HealthcareCaps out-of-pocket health costs for retirees, improving access to care for seniors not on Medicare.80% confidence ✓ Labor & EmploymentSupports Labor & EmploymentExpands public retiree benefits via increased Social Security adjustments and capped health costs, strengthening post-employment financial security for workers.90% confidence

Sub-Topics Pensions Medicare Retirement Benefits

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passed · Massachusetts · House Aug 18, 2025

HD 4991: An Act relative to Medicare coverage of end-stage renal disease

By Representative Stanley of Waltham, a petition (subject to Joint Rule 12) of Thomas M. Stanley relative to Medicare coverage of end-stage renal disease. Health Care Financing.

Topics ✓ HealthcareSupports HealthcareBill seeks Medicare coverage for end-stage renal disease, expanding access to critical healthcare services for patients requiring dialysis or transplants.95% confidence

Sub-Topics Medicare

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in committee · Massachusetts · Senate Aug 25, 2025

SD 2686: An Act relative to cannabis for Medicare eligible patients

By Mr. Crighton, a petition (accompanied by bill) (subject to Joint Rule 12) of Brendan P. Crighton for legislation relative to cannabis for Medicare eligible patients. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill seeks Medicare coverage for cannabis, expanding healthcare access for eligible patients under public health program framework95% confidence

Sub-Topics Medicare

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introduced · Massachusetts · House

HD 1566: An Act relative to access to psychiatric collaborative care

This bill requires Massachusetts insurers and health plans to pay primary care providers at minimum rates equal to Medicare's standard rates for psychiatric collaborative care services, using specific billing codes (99492, 99493, 99494, and G2214). It directly affects primary care teams, psychiatric consultants, and insurers by mandating annual payment adjustments to match Medicare rates for these services. The bill specifies that these services must be paid on a fee-for-service basis, not included in bundled payments. This applies to Medicaid managed care organizations, private health insurers, and all health plans operating in Massachusetts.

Topics ✓ HealthcareSupports HealthcareRequires insurers to pay Medicare rates for psychiatric collaborative care (99492-99494, G2214), ensuring fair reimbursement and improving mental health access through mandated payment standards.95% confidence

Sub-Topics Medicare Mental Health Primary Care

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passed · Massachusetts · House Jun 17, 2026

H 1415: An Act to protect qualified medicare beneficiaries from improper billing

By Representative Ultrino of Malden, a petition (accompanied by bill, House, No. 1415) of Steven Ultrino for legislation to protect qualified medicare beneficiaries from improper billing. Health Care Financing.

Topics ✓ HealthcareSupports HealthcareProtects Medicare beneficiaries from improper billing, safeguarding patient rights and preventing financial harm in healthcare services.95% confidence

Sub-Topics Medicare

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introduced · Massachusetts · House

HD 1387: An Act relative to group insurance costs for certain public retirees

HD 1387 limits out-of-pocket costs for prescription drugs for public employees and retirees. It sets a maximum annual cap of $2,000 for individual coverage and $4,000 for family coverage on deductibles and copayments for covered pharmaceutical services. The bill applies to active and retired public employees, their dependents, and survivors of deceased employees under non-Medicare group health insurance plans, including municipal subscribers. This directly affects public sector workers and retirees enrolled in such health plans.

Topics ✓ HealthcareSupports HealthcareBill caps prescription drug costs ($2k/$4k max) for public retirees/employees under group insurance, directly reducing out-of-pocket expenses and improving access to pharmaceutical services.95% confidence

Sub-Topics Medicare Prescription Drugs

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introduced · Massachusetts · House

HD 2566: An Act protecting patients from surprise bills related to emergency ambulance service

This bill (HD 2566) requires health insurance carriers to pay emergency ambulance service providers directly for covered services, rather than billing patients. It sets payment rates based on municipal rates (if established) or 325% of Medicare rates, capping patient cost-sharing at $100. The law protects insured patients from surprise bills and prohibits providers from billing them further after receiving payment, while also limiting charges for uninsured patients to Medicare rates. It applies to all emergency ambulance services requiring immediate response, affecting patients, insurers, and ambulance providers across Massachusetts.

Topics ✓ HealthcareSupports HealthcarePrevents patient surprise billing for emergency ambulance services by mandating direct insurer payments, capping out-of-pocket costs at $100, and protecting patients from further billing, enhancing financial access to emergency care.95% confidence

Sub-Topics Medicare

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introduced · Massachusetts · House

HD 3404: An Act to protect qualified medicare beneficiaries from improper billing

This bill prohibits Medicare, Medicare Advantage, and MassHealth providers from billing QMB (Qualified Medicare Beneficiary) beneficiaries for Medicare Part A or Part B cost-sharing, such as deductibles or co-pays. It directly protects low-income Medicare beneficiaries in the QMB eligibility group, who qualify for full Medicare cost-sharing assistance under federal and state law. Providers who violate this rule face potential sanctions, including monetary fines, within 90 days of the law taking effect, though minor errors or good-faith mistakes may be considered mitigating circumstances. The law aims to prevent improper billing by requiring providers to comply with existing cost-sharing protections for this specific beneficiary group.

Topics ✓ HealthcareSupports HealthcareProtects low-income Medicare beneficiaries from cost-sharing charges, ensuring access to care without financial burden95% confidence

Sub-Topics Medicare

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in committee · Massachusetts · Senate Oct 20, 2025

SD 3096: An Act relative to Medicare coverage of end-stage renal disease

By Mr. Gómez, a petition (accompanied by bill) (subject to Joint Rule 12) of Adam Gómez for legislation relative to Medicare coverage of end-stage renal disease. Health Care Financing.

Topics ✓ HealthcareSupports HealthcareBill explicitly expands Medicare coverage for end-stage renal disease treatment, directly improving patient access to essential healthcare services.95% confidence

Sub-Topics Medicare

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