Sen. Becca Rausch

Maddy summaryThis bill ensures that individuals in Massachusetts can continue seeing their mental health providers even if those providers are removed from an insurance network or the insurance company changes. It defines a "continuing course of treatment" as having at least one visit in the past four months for the same condition or similar symptoms. Under the new rules, insurance carriers must pay the full in-network rate to providers who are out-of-network due to disenrollment or plan changes, unless the removal was due to fraud or quality issues. Patients may face a higher co-payment only if the carrier proves that using an out-of-network provider significantly increases costs, and no new deductibles or additional charges are allowed for this coverage.

Maddy summaryThis bill proposes to create a new state system called the Massachusetts Health Care Trust to provide universal health coverage for all residents. It establishes a Board of Trustees and an Executive Director to manage the program, which is designed to offer affordable and equitable access to medical services for everyone in the Commonwealth. The legislation amends existing state laws to add this new chapter, effectively replacing or supplementing the current insurance model with a single-payer approach.

Maddy summaryThis bill amends Massachusetts state law to change the frequency of required pediatric care appointments from once every year to once per calendar year. The change directly affects parents and guardians of children who must schedule well-child visits with healthcare providers. By removing the word "annually" and replacing it with "once per calendar year," the legislation clarifies that children should receive at least one check-up within each calendar year rather than on a rolling twelve-month cycle. This adjustment ensures that the timing of these essential medical visits aligns with the calendar year without altering the overall requirement for regular pediatric care.

Maddy summaryThis bill amends Massachusetts laws to improve transparency and affordability for prescription drugs by updating how different types of medications are defined. It specifically clarifies the legal definitions of biosimilars, brand name drugs, and generic drugs to ensure consistency across the state's healthcare system. Additionally, the legislation expands coverage to include self-insured health plans, which were previously excluded from certain reporting requirements. By refining these categories and broadening the scope of included plans, the bill aims to provide clearer data on drug costs for consumers and insurers.

Maddy summaryThis bill amends Massachusetts state law to prohibit insurance companies from discriminating against hospitals and pharmacies that participate in the federal 340B drug discount program. It specifically forbids insurers from charging these entities lower reimbursement rates, imposing unique fees or audit requirements, or restricting their network participation solely because they dispense discounted drugs. The legislation aims to ensure that 340B-covered entities are treated the same as other pharmacies regarding insurance claims, fees, and contractual terms. By banning these specific practices, the bill seeks to protect the financial stability of safety-net providers that rely on these federal discounts to offer affordable care.

Maddy summaryThis bill establishes a cost-sharing assistance program in Massachusetts to help low-income individuals afford their health insurance deductibles, co-pays, and co-insurance. It targets applicants earning up to 500 percent of the federal poverty level who are enrolled in employer-sponsored health plans that meet minimum value and affordability standards. The program would provide supplemental coverage to bridge the gap between the costs of their current employer plan and those of plans available through the state health insurance connector. Additionally, the bill requires the state health insurance connector authority to evaluate the program's impact on healthcare access and equity, submitting a report to the legislature by December 1, 2029. The law is scheduled to take effect on January 1, 2026.

Maddy summaryThis bill directs the Massachusetts Health Insurance Connector Authority to run a five-year pilot program starting in 2024 that expands affordable health coverage to individuals earning up to 500 percent of the federal poverty level. Under the program, eligible applicants between 300 and 500 percent of the poverty line would gain access to health plans with at least 90 percent actuarial value, while funding for these subsidies would come from the Commonwealth Care Trust Fund. The legislation also requires the Connector Authority to evaluate the program's impact on healthcare access, costs, and health equity by collecting specific data annually and submitting reports to state officials by December 2026 and December 2029.

Maddy summaryThis bill requires that community health centers in Massachusetts be reimbursed using a specific payment method known as a prospective payment system. The law mandates that this reimbursement approach aligns with federal guidelines established in the United States Code as of January 1, 2023. By updating state statutes, the bill ensures that insurers and other payers follow this standardized calculation for services provided by these federally qualified health centers. The change directly affects how these healthcare facilities are paid for patient care and aims to create consistency between state and federal payment rules.

Maddy summaryThis bill requires insurance companies in Massachusetts to pay safety net hospitals at least as much as the state's average commercial rate for inpatient and outpatient services. It specifically targets acute care hospitals that treat at least 25% of their patients through Medicaid and serve communities facing health disparities due to race, ethnicity, or socioeconomic status. If an insurer pays these hospitals less than the statewide average, their commercial insurance rates will be automatically rejected by the state insurance commissioner unless they provide proof of higher payments. The law applies to all commercial health plans starting January 1, 2023, aiming to ensure these hospitals receive fair reimbursement to maintain access to care.

Maddy summaryThis bill prohibits insurance companies and other payers from discriminating against healthcare facilities that participate in the federal 340B drug discount program. It requires payers to reimburse these facilities and their contract pharmacies at the same rate they would pay any other pharmacy, preventing lower payments, extra fees, or different audit requirements based on the facility's status. The legislation also bans payers from imposing conditions that steer patients away from receiving discounted drugs at these facilities. By amending state laws, the bill aims to ensure that organizations serving vulnerable populations can maintain access to affordable medications without facing financial penalties or administrative barriers.