Healthcare

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

Track

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

Track

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

Track

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

Track

passed · Massachusetts · House Sep 18, 2025

H 1133: An Act relative to patient financial protection

By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 1133) of Marjorie C. Decker relative to insurance coverage out-of-pocket limits for prescription drugs. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill establishes out-of-pocket limits for prescription drugs, reducing patient financial burden and protecting access to medications under insurance coverage.95% confidence

Sub-Topics Insurance

Track

passed · Massachusetts · Senate Dec 8, 2025

S 1409: An Act to reform mental health supports and increase public safety

By Ms. Kennedy (by request), a petition (accompanied by bill, Senate, No. 1409) of Gary Lowell, for legislation to mandate psychiatric evaluations in a hospital emergency room if a restraint authorization is given. Mental Health, Substance Use and Recovery.

Topics ✓ Criminal JusticeSupports Criminal JusticeMandates psychiatric evaluations during ER restraints, diverting mental health crises from criminal justice system to appropriate care, aligning with reform goals.85% confidence ✓ HealthcareSupports HealthcareMandates psychiatric evaluations in ERs for restraint cases, directly strengthening mental health access and safety protocols within healthcare services.95% confidence

Sub-Topics Hospitals Mental Health Substance Abuse

Track

passed · Massachusetts · Senate Jan 7, 2026

S 1626: An Act to protect essential health services

S 1626, sponsored by Senator Bruce Tarr, aims to protect essential health services under Public Health legislation. The bill seeks to establish safeguards for critical healthcare services but lacks specific details in the provided abstract about which services or how protections would be implemented. Without additional context on its provisions or affected populations, this summary reflects only the bill's stated purpose as described in its title and abstract. The abstract does not specify mechanisms, affected groups, or concrete policy changes.

Topics ✓ HealthcareSupports HealthcareBill title explicitly aims to protect essential health services, directly aligning with support indicators like safeguarding critical care under public health legislation.95% confidence

Sub-Topics Public Health

Track

passed · Massachusetts · House Jan 28, 2026

H 1299: An Act to increase enrollment in affordable health plan networks

By Representative Robertson of Tewksbury, a petition (accompanied by bill, House, No. 1299) of David Allen Robertson for legislation to increase enrollment in affordable health plan networks. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill explicitly aims to increase enrollment in affordable health plan networks, directly expanding access to healthcare coverage.95% confidence

Sub-Topics Insurance

Track

passed · Massachusetts · House Mar 12, 2026

H 1246: An Act establishing a public health option

By Representative Lewis of Framingham, a petition (accompanied by bill, House, No. 1246) of Jack Patrick Lewis that the Commonwealth Connector Authority provide for a public health insurance option. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill establishes a public health insurance option to expand coverage through Commonwealth Connector Authority, directly advancing healthcare access and funding.95% confidence

Sub-Topics Insurance Public Health

Track

passed · Massachusetts · House Jan 28, 2026

H 1313: An Act relating to patient choice in dispensing of clinician-administered drugs

By Representative Sabadosa of Northampton, a petition (accompanied by bill, House, No. 1313) of Lindsay N. Sabadosa relative to patient choice in dispensing of clinician-administered drugs. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill promotes patient autonomy in drug dispensing, enhancing access to clinician-administered treatments without restricting options or coverage.90% confidence

Track