HD 3016 requires Massachusetts to fund supportive care services for low-income seniors aged 55+ living in qualifying rental housing projects. It mandates the Executive Office of Health and Human Services to pay housing sponsors $2,500 annually per MassHealth enrollee residing in projects with at least 50 units, where MassHealth residents are the majority and cluster contracting with homecare agencies is in place. The law also requires annual reports to the legislature tracking the number of Medicaid recipients in these projects and cost savings from the cluster contracting model. This directly affects qualifying senior housing projects and their residents enrolled in MassHealth.
By Mr. Crighton, a petition (accompanied by bill, Senate, No. 695) of Brendan P. Crighton for legislation relative to health insurance coverage by athletic trainers. Financial Services.
HD 3870 establishes a Massachusetts Physicians Scholarship Program (PSP) that covers tuition costs for up to 10 years for medical students enrolled in accredited programs within the state. In exchange, recipients must commit to four years of full-time work in a Massachusetts healthcare facility after graduation. The program targets medical students to address physician shortages by incentivizing training and retention within the state, with annual reporting required to the Department of Public Health. It directly affects medical students seeking education in Massachusetts and healthcare facilities needing qualified physicians.
This bill exempts medications used to treat opioid use disorder from prior authorization requirements under Massachusetts Medicaid. It directly affects Medicaid patients seeking these specific treatments and healthcare providers prescribing them. The key change modifies the definition of "Step Therapy Protocol" to explicitly exclude opioid use disorder medications, ensuring they are covered without needing separate approval from the state health division. This removes administrative barriers for accessing critical treatment options.
This bill (HD 1026) requires the Division to cover medically necessary habilitative and rehabilitative treatments for adults aged 21+ who have developmental disabilities, intellectual disabilities, or autism spectrum disorder and are covered under Chapter 118E. It mandates coverage for treatments like applied behavior analysis (provided by licensed professionals) and both dedicated and non-dedicated communication devices (including tablets), as determined medically necessary by a licensed physician or psychologist. The policy directly affects eligible adults with these diagnoses, ensuring state-funded access to specific therapies and assistive devices previously not guaranteed under the existing coverage. It does not change eligibility criteria but expands required coverage for defined treatments and devices.
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People with Disabilities
HD 2485 prohibits discrimination against people with disabilities in Massachusetts healthcare. It bans healthcare providers and entities from denying lifesaving treatment or prioritizing care based on assumptions about a person's quality of life or "worth" due to disability, or using metrics that value lives with disabilities less than others. The law specifically prohibits conditioning treatment on having a "Do Not Resuscitate" order or advance directive, while allowing consideration of short-term survival likelihood in crisis care. This applies to all public and private healthcare entities in Massachusetts, ensuring equal access to treatment regardless of disability.
This bill prohibits discrimination against entities participating in the federal 340B drug discount program. It requires insurers and drug distributors to pay 340B-covered entities (like community health centers and safety-net hospitals) and their contract pharmacies the same rate as non-340B providers for covered drugs, without imposing special requirements or modifiers for 340B drugs. The law also protects patients' choice to receive 340B drugs from participating providers without interference. Violations are treated as unfair trade practices under Massachusetts law, enforced by the Attorney General and pharmacy board. The bill directly affects 340B program participants, their pharmacy partners, insurers, and drug manufacturers/distributors operating in Massachusetts.
Bill H 4489 requires pharmaceutical manufacturers to disclose pricing information - including wholesale cost trends, research spending, and explanations for price changes - to a state commission. The commission reviews this data to assess whether drug pricing is unreasonable compared to a "proposed value" and then issues public recommendations, such as bulk purchasing programs or adjusted insurance costs, to improve affordability. Manufacturers face potential civil penalties of up to $500,000 for non-compliance or providing false information. The bill explicitly states its process does not affect individual patient treatment decisions or health plan coverage determinations.
This bill requires all health insurance plans in Massachusetts - including those covering state employees, group plans, and individual policies - to cover the cost of specialized medical formulas (for home use, administered orally or via tube feeding) when prescribed by a doctor for specific serious conditions. It applies to policies governed by Massachusetts law, including group insurance, hospital service plans, and medical service agreements. Coverage is limited to formulas proven effective for conditions like inherited metabolic disorders, Crohn's disease, or severe food allergies, as documented by a physician's written order stating medical necessity. The bill explicitly distinguishes these medically required formulas from general nutritional supplements taken without a medical need.
HD 963 requires all health insurance plans in Massachusetts to cover "prenatal pediatric visits" - defined as appointments between a pregnant person and a pediatrician to establish a family-pediatric partnership - as recommended by the American Academy of Pediatrics. The bill directly affects state employees, Medicaid members, and individuals with private health insurance, group hospital plans, and health maintenance contracts. Key provisions mandate coverage for these visits in state employee plans (Ch. 32A), Medicaid managed care (Ch. 118E), private health insurance (Ch. 175), and other covered plans (Chs. 176A, 176B, 176G). Insurers must also provide written notice to members about this coverage, prominently included in annual communications. The policy change standardizes this specific preventive care coverage across multiple insurance categories without altering eligibility or funding.
