Healthcare

passed · Massachusetts · Senate Jan 29, 2026

S 809: An Act relative to patient access to biomarker testing to provide appropriate therapy

SD 532 requires health insurers and government health plans to cover biomarker testing for diagnosis, treatment, and monitoring of diseases when supported by specific evidence, including FDA approvals, clinical guidelines, or CMS determinations. It directly affects patients enrolled in Commonwealth group insurance (e.g., state employees) and Medicaid beneficiaries. The bill mandates coverage without unnecessary disruptions (like multiple biopsies) and sets strict timelines: insurers must approve or deny prior authorization requests within 72 hours (24 hours for urgent cases), with requests deemed approved if no response is received. Patients and providers also gain access to clear processes for appealing coverage denials.

Topics ✓ HealthcareSupports HealthcareBill enables patient access to biomarker testing for tailored therapy, improving treatment options and access to appropriate care.90% confidence

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passed · Massachusetts · House Aug 28, 2025

H 1312: An Act relative to Insurance Coverage for Doula Services

HD 2576 requires most health insurance plans in Massachusetts to cover doula services without cost-sharing (like deductibles or copays) for individuals seeking pregnancy, birth, and postpartum support. It defines doula services as non-medical physical, emotional, and informational support during pregnancy, childbirth, adoption, loss, or postpartum, mandating minimum coverage of 20 hours of prenatal/postpartum care per pregnancy plus continuous labor support. Insurance plans must reimburse doulas at MassHealth rates, eliminate referral requirements, follow state credentialing standards, and cover additional hours for heightened needs. The bill applies to state employee insurance, private health plans, and hospital service plans.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for doula services, expanding maternal health access and aligning with healthcare coverage expansion indicators.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Aug 28, 2025

S 836: An Act to improve outcomes for persons with limb loss and limb difference

By Mr. Velis, a petition (accompanied by bill, Senate, No. 836) of John C. Velis and Joanne M. Comerford for legislation to authorize insurance coverage for prosthetic devices and orthotic devices. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill explicitly authorizes insurance coverage for prosthetic/orthotic devices, expanding health coverage access for patients with limb loss.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Dec 8, 2025

S 685: An Act relative to transparency of consumer health insurance rights

This bill requires health insurance companies in Massachusetts to clearly display key plan details on enrollment cards. Specifically, insurers must list whether a plan is fully insured, the carrier and plan name, member service phone numbers, copay amounts for common services, deductible details, and any other required insurance commissioner information. These disclosures directly affect consumers by making essential coverage terms more visible at sign-up. The law aims to improve transparency about costs and plan features without altering insurance benefits or regulations.

Topics ✓ HealthcareSupports HealthcareBill mandates transparency in health insurance rights, enhancing consumer protections and access to coverage details per its title and summary.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Jan 8, 2026

H 1128: An Act preserving access to treatment for patients with serious mental illnesses

This bill (HD 3104) defines "serious mental illness" in Massachusetts law to include eight specific conditions (like schizophrenia, bipolar disorder, and PTSD) as listed in the DSM. It directly affects patients diagnosed with these conditions and their health insurers. The key provision prohibits insurance companies and health plans from requiring prior authorization, step therapy, or other delays for FDA-approved medications treating these defined mental illnesses. This removes administrative barriers to accessing necessary medications for these patients. The law applies to all health insurance carriers and plans operating under Massachusetts Chapter 176O and Chapter 118E.

Topics ✓ HealthcareSupports HealthcareBill preserves access to mental health treatment for serious illnesses, directly supporting patient access and mental health services per topic description.95% confidence

Sub-Topics Mental Health

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passed · Massachusetts · House Jan 8, 2026

H 1229: An Act to further define medical necessity determinations

This bill defines specific mental health treatment services and mandates coverage without preauthorization for two groups. It applies to Massachusetts Commonwealth employees (active/retired) covered under group insurance and Medicaid recipients. The bill requires coverage for: mental health acute treatment (24-hour inpatient care), crisis stabilization services (up to 14 days), community-based acute treatment (CBAT, up to 21 days for youth), and intensive community-based acute treatment (ICBAT, up to 14 days for youth). Facilities must notify insurers within 48 hours of admission, and medical necessity must be determined by the treating clinician with patient input - no preauthorization is required, though limited utilization reviews may begin after specified days (e.g., day 7 for crisis services).

Topics ✓ HealthcareSupports HealthcareDefines medical necessity determinations to prevent arbitrary insurance denials, improving patient access to covered care without explicit funding cuts or restrictions.85% confidence

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passed · Massachusetts · House Jun 17, 2026

H 1418: An Act to provide funding for the African Diaspora Mental Health Association's State-of-the-Art Clinic

This bill appropriates $1.5 million from the state general fund to the African Diaspora Mental Health Association (ADMHA) in Springfield, Massachusetts, to complete its new mental health and substance use disorder clinic and expand services. The funding will cover physical infrastructure, telehealth technology, culturally tailored programs for opioid recovery and violence prevention, staff training on cultural competence, and community outreach initiatives. ADMHA, the only minority-owned mental health clinic in Western Massachusetts, will use the funds to directly serve African American and underserved communities. ADMHA must report on fund usage and program outcomes to the state within one year of receiving the funds.

Topics ✓ HealthcareSupports HealthcareDirectly funds a mental health clinic, advancing mental health services under healthcare topic per bill title and summary.95% confidence

Sub-Topics Primary Care

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passed · Massachusetts · House Jun 17, 2026

H 1412: An Act improving access to post acute services

HD 3406 aims to improve access to post-acute care services for MassHealth patients in Massachusetts by streamlining administrative processes and expanding community resources. The bill requires the Office of Medicaid to revise beneficiary notices, adopt transparent appeal procedures, and develop community discharge pathways for patients with chronic, medically complex conditions. It also establishes a complex care ombudsman program to assist hospitals with discharges and a pilot program to increase skilled nursing facility capacity for dementia, psychiatric, and geriatric patients. These changes target delays in transferring medically ready patients from hospitals to community-based care, freeing up acute care beds and improving care coordination.

Topics ✓ HealthcareSupports HealthcareBill explicitly aims to improve access to post-acute healthcare services, directly aligning with support indicators like enhanced patient access under healthcare financing.95% confidence

Sub-Topics Long-Term Care

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passed · Massachusetts · House Apr 16, 2026

H 1366: An Act to protect medically fragile children

This bill requires Massachusetts to increase funding for continuous skilled nursing care for medically fragile children covered by MassHealth (state Medicaid). It mandates specific staffing targets: filling at least 75% of authorized nursing hours by 2025, 80% by 2026, and 85% by 2027 onward, with provisions to boost nurse wages. The state must also require MassHealth to submit annual reports tracking staffing levels, appeals for denied care, and reductions in authorized hours. The bill aims to improve access to consistent nursing care for vulnerable children by ensuring funding meets these targets and reviewing wage rates paid to providers.

Topics ✓ HealthcareSupports HealthcareRegulates skilled nursing criteria to protect medically fragile children's access, strengthening healthcare access and patient protection per bill title and summary.90% confidence

Sub-Topics Children's Health Long-Term Care

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passed · Massachusetts · House Jan 23, 2026

H 1230: An Act mandating access to cancer screenings for firefighters through health care benefits plans or programs provided by the public employer

This bill requires public employers (like state fire departments, cities, towns, or fire districts) to provide full-time firefighters with cancer screenings starting three years after they begin working and every three years thereafter. It directly affects firefighters employed by Massachusetts fire departments, including those at military reservations, air bases, and specific regional zones. The screenings must cover 11 specific cancers (such as colon, lung, breast, and prostate), with all costs covered by the employer's health plan - no co-pays, deductibles, or out-of-pocket expenses for firefighters. This mandates a regular, employer-funded health benefit without requiring firefighter contributions.

Topics ✓ HealthcareSupports HealthcareMandates cancer screenings for firefighters through public employer health plans, expanding preventive care access for a high-risk group under existing healthcare coverage.90% confidence ✓ Labor & EmploymentSupports Labor & EmploymentMandates cancer screenings for firefighters via employer health benefits, enhancing workplace safety protections for high-risk workers in Labor & Employment.95% confidence

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