By Mr. Tarr, a petition (accompanied by bill, Senate, No. 912) of Bruce E. Tarr for legislation to ensure temporary nursing service agency quality. Health Care Financing.
By Mr. Tarr, a petition (accompanied by bill, Senate, No. 914) of Bruce E. Tarr and James B. Eldridge for legislation relative to spouses as caregivers. Health Care Financing.
Maddy summaryThis bill (SD 85) establishes rules for pharmacy benefits managers and covered entities regarding reimbursement rates for prescription drugs. It requires that drugs placed on "maximum allowable cost lists" (reimbursement limits) must meet specific FDA rating criteria and have therapeutically equivalent alternatives available. Pharmacies must receive transparent cost information, and reimbursement rates must cover actual pharmacy acquisition costs (using National Average Drug Acquisition Cost as a benchmark). The bill also creates a 7-business-day appeals process for pharmacies to challenge rates, with retroactive payment adjustments if appeals are approved, and prohibits retroactive discounts on claims. These requirements apply to all pharmacy benefits managers and covered entities operating in Massachusetts.
Maddy summarySD 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.
Maddy summaryThis bill requires health insurance policies in Massachusetts to cover scalp hair prostheses and facial medical pigmentation (like eyebrow replacements) for specific conditions. It directly affects individuals who have lost scalp or facial hair due to cancer/leukemia treatment, alopecia areata, alopecia totalis, non-classical 21-hydroxylase deficiency, or injury - not natural aging. Insurance must cover these items on a nondiscriminatory basis, subject to a physician’s written statement confirming medical necessity, and at a minimum equal to coverage for chemo-related hair loss. The bill amends multiple insurance law sections to mandate this coverage without expanding government programs.
Maddy summaryThis bill expands who qualifies as a "family member" eligible to be paid as a caregiver in MassHealth-funded home and community-based services. It specifically adds legally liable family members - such as biological/adoptive/foster/step parents, legal guardians, powers of attorney, and adult children - to the definition. The law requires the Executive Office of Health and Human Services to submit a state plan amendment or waiver to implement this change. It directly affects MassHealth programs that pay family caregivers, allowing more relatives to provide care while being compensated. The change applies to programs funded under Chapter 118E of Massachusetts law.
Maddy summarySD 992 creates a Perinatal Behavioral Health Care Workforce Trust Fund to address shortages in mental and behavioral health providers specializing in perinatal care (during pregnancy and up to one year after birth). The fund provides grants to organizations for training programs aimed at growing and diversifying this workforce, with priority given to programs serving medically underserved populations or areas with racial, geographic, or health outcome disparities. Grantees must report annually on grant recipients, participant demographics (including race, gender, and zip code), and how programs impact workforce sustainability and healthcare shortages. This bill directly affects perinatal health providers and the communities they serve, particularly those facing systemic healthcare gaps.
By Mr. Crighton, a petition (accompanied by bill, Senate, No. 692) of Brendan P. Crighton, James B. Eldridge and Bruce E. Tarr for legislation to facilitate timely access to quality health care by expanding access to patient navigation. Financial Services.
By Mr. Durant, a petition (accompanied by bill, Senate, No. 1077) of Peter J. Durant and Bruce E. Tarr for legislation to maintain parity in legal services for small property owners by providing financial assistance to both local and statewide programs that serve eligible clients. The Judiciary.
By Mr. O'Connor, a petition (accompanied by bill, Senate, No. 1602) of Patrick M. O'Connor for legislation to improve pediatric cancer research. Public Health.
