This bill establishes a new framework to track and increase the share of total healthcare spending dedicated to primary care in the Commonwealth. It creates specific definitions for primary care expenditures and infrastructure support, requiring the state to set annual spending targets that rise from 9% of total healthcare costs in 2030 to 15% by 2036. The legislation mandates that the state monitor these targets and report progress annually, while also requiring officials to ensure that increased primary care funding does not lead to higher overall healthcare costs or insurance premiums. Additionally, the bill updates procedures for identifying healthcare entities with excessive cost growth and may require them to submit performance improvement plans.
Report of the Health Policy Commission (pursuant to Chapter 343 of the Acts of 2024) submitting its Primary Care Access, Delivery, and Payment Task Force seventh report
This bill formally submits a report from the Massachusetts Health Policy Commission's task force regarding primary care, access, delivery, and payment to the state legislature. The document includes an analysis of provider registration data and commercial database records to inform future healthcare policy. It specifically identifies certain provider organizations, such as Accountable Care Partnership Plans and Primary Care Accountable Care Organizations, as required participants in the state's registration program. The bill is primarily procedural, serving to place the executive office's findings on file for legislative review.
Senate, June 11, 2026 -- The committee on Senate Ways and Means, to whom was referred the Senate Bill relative to primary care for you (Senate, No. 867),- reports, recommending that the same ought to pass with an amendment substituting a new draft with the same title (Senate, No. 3116).
Report of the Health Policy Commission (pursuant to Chapter 343 of the Acts of 2024) submitting fifth report and recommendations to assess the impact of health plan design on patient access to primary care services
Report of the Health Policy Commission (pursuant to Chapter 343 of the Acts of 2024) submitting its Primary Care Access, Delivery, and Payment Task Force (PCTF)’s recommendation to develop a standardized set of data and reporting requirements for primary care payments
Report of the Health Policy Commission (pursuant to Chapter 343 of the Acts of 2024) submitting the fourth deliverable of the Primary Care Access, Delivery, and Payment Task Force (Primary Care Task Force) report
H 5015 requires Massachusetts health insurers and health plans to reimburse community health centers at rates equivalent to MassHealth payments for the same services. It applies to all entities paying for Federally Qualified Health Center services, including private insurers, HMOs, and dental corporations. The law mandates that reimbursement must match MassHealth's payment methodology as of January 1, 2025, ensuring community health centers receive the same revenue they would get through Medicaid. Insurers must annually report compliance with this standard to the state insurance division.
H 5022 prohibits health insurance companies from denying payment for covered services solely because a patient received a referral from a doctor outside the insurance network. This affects patients seeking care from non-network providers and requires insurers to cover services under the same terms as network referrals. The bill amends multiple sections of Massachusetts health insurance laws (including Chapters 32A, 32B, 94C, 175, 176A, 176B, 176G, and 176I) to include this uniform rule. It takes effect one year after enactment for all new, renewed, or amended insurance contracts.
This bill (H 4951) requires Massachusetts health insurance plans and state employee health coverage to fully cover HIV prevention medications (like PrEP) without cost-sharing (no copays, deductibles) or prior approval delays. It applies to state employees, retirees, and all health insurance policies (individual and group) covering hospital/surgical expenses. Key provisions mandate that insurers cannot deny coverage based on the type of healthcare provider prescribing the medication or where it's prescribed (e.g., clinic vs. hospital), as long as the provider is licensed. The law also ensures coverage includes necessary monitoring services like lab tests and counseling, as defined by federal health agencies.
