HOUSE . . . . . . . . . . . . . . No. 5143
The Commonwealth of Massachusetts
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The committee of conference on the disagreeing votes of the two branches with reference
to the Senate amendments (striking out all after the enacting clause and inserting in place thereof
the text contained in Senate document numbered 2921; and striking out the title and inserting in
place thereof the following title: “An Act relative to accessing harm reduction initiatives.”) of the
House Bill relative to treatments and coverage for substance use disorder and recovery coach
licensure (House, No. 4758), reports recommending passage of the accompanying bill (House, No.
5143). December 17, 2024.
Adrian C. MadaroBrenden P. CrightonAlice Hanlon PeischJohn C. VelisMichael J. SoterRyan C. Fattman 1 of 51
FILED ON: 12/17/2024
HOUSE . . . . . . . . . . . . . . . No. 5143
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
_______________
An Act relative to treatments and coverage for substance use disorder and recovery coach
licensure.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1SECTION 1. Chapter 32A of the General Laws is hereby amended by striking out section 17Q,
2as appearing in the 2022 Official Edition, and inserting in place thereof the following section:-
3 Section 17Q. (a) The commission shall develop a plan to provide active or retired
4employees insured under the group insurance commission adequate coverage and access to a
5broad spectrum of pain management services, including, but not limited to, non-medication,
6nonsurgical treatment modalities and non-opioid medication treatment options that serve as
7alternatives to opioid prescribing, in accordance with guidelines developed by the division of
8insurance.
9 (b) No such coverage offered by the commission shall, relative to pain management
10services identified by the commission pursuant to subsection (a), require a member to obtain
11prior authorization for non-medication, nonsurgical treatment modalities that include restorative
12therapies, behavioral health approaches or integrative health therapies, including acupuncture,
13chiropractic treatments, massage and movement therapies. 2 of 51
14 (c)(1) The plan developed pursuant to subsection (a) shall be subject to review by the
15division of insurance. In its review, the division shall consider the adequacy of access to a broad
16spectrum of pain management services and any policies that may create unduly preferential
17coverage to prescribing opioids without other pain management modalities.
18 (2) No coverage offered by the commission to an active or retired employee of the
19commonwealth insured under the group insurance commission shall establish utilization
20controls, including prior authorization or step therapy requirements, for clinically appropriate
21non-opioid drugs approved by the United States Food and Drug Administration for the treatment
22or management of pain that are more restrictive or extensive than the least restrictive or
23extensive utilization controls applicable to any clinically appropriate opioid drug.
24 (d) The commission shall annually distribute educational materials to providers within
25their network and to members about the pain management access plan developed pursuant to
26subsection (a) and shall make information about the plan publicly available on its website.
27 SECTION 2. Said chapter 32A is hereby further amended by inserting after section 17W
28the following 2 sections:-
29 Section 17X. (a) Coverage offered by the commission to an active or retired employee of
30the commonwealth insured under the group insurance commission shall provide coverage for
31prescribed, ordered or dispensed opioid antagonists, as defined in section 19B of chapter 94C
32and used in the reversal of overdoses caused by opioids; provided, however, that the coverage for
33such prescribed, ordered or dispensed opioid antagonists shall not require prior authorization;
34and provided further, that a prescription from a health care practitioner shall not be required for
35coverage or reimbursement of opioid antagonists under this section. An opioid antagonist used in 3 of 51
36the reversal of overdoses caused by opioids shall not be subject to any deductible, coinsurance,
37copayments or out-of-pocket limits; provided, however, that cost-sharing shall be required if the
38applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt
39status as a result of the prohibition on cost-sharing for this service.
40 (b) The commission shall provide coverage and reimbursement for an opioid antagonist
41used in the reversal of overdoses caused by opioids as a medical benefit when dispensed by the
42health care facility in which the opioid antagonist was prescribed or ordered and shall provide
43coverage as a pharmacy benefit for an opioid antagonist used in the reversal of overdoses caused
44by opioids dispensed by a pharmacist, including an opioid antagonist dispensed pursuant to
45section 19B of chapter 94C; provided, however, that the rate to be reimbursed under the medical
46benefit shall not exceed the commission’s average in-network pharmacy benefit rate and the
47health care facility shall not balance bill the patient.
48 Section 17Y. The commission shall provide to any active or retired employee of the
49commonwealth who is insured under the group insurance commission coverage for the provision
50of services by a recovery coach licensed or otherwise authorized to practice pursuant to chapter
51111J, regardless of the setting in which the services are provided; provided, however, that such
52services shall be within the lawful scope of practice of a recovery coach. The contractual rate for
53these services shall be not less than the prevailing MassHealth rate for recovery coach services.
54The benefits in this section shall not be subject to any deductible, coinsurance, copayments or
55out-of-pocket limits; provided, however, that cost-sharing shall be required if the applicable plan
56is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result
57of the prohibition on cost-sharing for the service. Recovery coach services shall not require prior
58authorization. 4 of 51
59 SECTION 3. Section 18 of chapter 94C of the General Laws, as appearing in the 2022
60Official Edition, is hereby amended by striking out subsection (e) and inserting in place thereof
61the following subsection:-
62 (e) Practitioners who prescribe controlled substances, except veterinarians, shall be
63required, as a prerequisite to obtaining or renewing their professional licenses, to complete
64appropriate training relative to: (i) effective pain management including, but not limited to: (A)
65appropriate, available non-opioid alternatives for the treatment of pain; (B) the advantages and
66disadvantages of the use of non-opioid treatment alternatives, considering a patient’s risk of
67substance misuse; and (C) the options for referring or prescribing appropriate non-opioid
68treatment alternatives based on the practitioner’s clinical judgment and following generally
69accepted clinical guidelines, taking into consideration the preference and consent of the patient
70and the educational information described in section 21; (ii) the risks of misuse and addiction
71associated with opioid medication; (iii) the identification of patients at risk for substance misuse;
72(iv) counseling patients about the side effects, risks, addictive nature and proper storage and
73disposal of prescription medications; (v) the appropriate prescription quantities for prescription
74medications that have an increased risk of misuse and addiction, including a patient’s option to
75fill a prescription for a schedule II controlled substance in a lesser quantity than indicated on the
76prescription pursuant to subsection (d¾); and (vi) opioid antagonists, overdose prevention
77treatments and information to advise patients on both the use of and ways to access opioid
78antagonists and overdose prevention treatments. The boards of registration for each professional
79license that require this training shall, in consultation with the department, relevant stakeholders
80and experts in the treatment and management of acute and chronic pain, develop the standards
81for appropriate training programs. For the purposes of this section, non-opioid treatment 5 of 51
82alternatives shall include, but shall not be limited to, medications, restorative therapies,
83interventional procedures, behavioral health approaches and complementary and integrative
84treatments.
85 SECTION 4. Said chapter 94C is hereby further amended by striking out section 19C, as
86so appearing, and inserting in place thereof the following section:-
87 Section 19C. The board of registration in pharmacy shall promulgate regulations
88requiring pharmacies located in areas with high incidence of opiate overdose, as determined by
89the board in consultation with the department, to maintain a continuous supply of opioid
90antagonists, as defined in section 19B; provided, however, that the continuous supply of opioid
91antagonists shall include opioid antagonists that are approved by the United States Food and
92Drug Administration to be sold over the counter without a prescription; and provided further,
93that such pharmacies shall notify the department if the supply or stock of opioid antagonist doses
94is insufficient to enable compliance with maintaining a continuous supply of opioid antagonists.
95 SECTION 5. Said chapter 94C is hereby further amended by inserting after section 19D
96the following section:-
97 Section 19D½. (a) For the purposes of this section, the following words shall, unless the
98context clearly requires otherwise, have the following meanings:
99 “Opioid antagonist”, as defined in section 19B.
100 “Substance use disorder treatment facility”, a facility licensed or approved by the
101department or the department of mental health to offer treatment for substance use disorder,
102including, but not limited to: (i) withdrawal management services; (ii) clinical stabilization 6 of 51
103services; (iii) transitional support services; (iv) residential support services; (v) community
104behavioral health center services; (vi) office-based opioid or addiction treatment services; or (vii)
105inpatient or outpatient substance use disorder services.
106 (b) A substance use disorder treatment facility shall, upon discharge of a patient who has:
107(i) a history of using opioids; (ii) been diagnosed with opioid use disorder; or (iii) experienced an
108opioid-related overdose, educate the patient on the use of opioid antagonists and dispense not
109less than 2 doses of an opioid antagonist to the patient or a legal guardian.
110 (c) The commissioner may promulgate rules and regulations necessary to implement this
111section.
112 SECTION 6. Section 21 of said chapter 94C, as appearing in the 2022 Official Edition, is
113hereby amended by striking out the third paragraph and inserting in place thereof the following
114paragraph:-
115 The department, in consultation with relevant stakeholders and experts in the treatment
116and management of acute and chronic pain, and based in part on the Pain Management Best
117Practices Inter-Agency Task Force Report issued by the United States Department of Health and
118Human Services, shall produce and distribute, either in written or electronic form, to pharmacies,
119not including institutional pharmacies, pamphlets for consumers relative to narcotic drugs,
120including opiates, that shall include educational information related to: (i) pain management and
121the use and availability of non-opioid alternatives for the treatment of acute and chronic pain,
122including, but not limited to: (A) information on available non-opioid alternatives for the
123treatment of pain, including non-opioid medications and non-pharmacological therapies; and (B)
124the advantages and disadvantages of the use of such non-opioid treatment alternatives; (ii) the 7 of 51
125consumer’s option to fill a prescription for a schedule II controlled substance in a lesser quantity
126than indicated on the prescription pursuant to subsection (d¾) of section 18; (iii) misuse and
127abuse of narcotics by adults and children; (iv) the risk of dependency and addiction associated
128with narcotics use; (v) proper storage and disposal of narcotics; (vi) addiction support and
129treatment resources; (vii) the telephone helpline operated by the bureau of substance addiction
130services established in section 18 of chapter 17; (viii) the risks of unintended overdoses
131associated with prescription opioid use, including, but not limited to: (A) mixing any opioid with
132stimulants or respiratory depressants, including, but not limited to, alcohol and benzodiazepines;
133and (B) changes in personal tolerance levels for persons with a history of overdose; and (ix) risk
134reduction measures to prevent, respond to and reverse an opioid overdose. A pharmacist shall
135distribute the pamphlet when dispensing a narcotic or controlled substance contained in schedule
136II or III; provided, however, that pharmacists shall not be required to distribute the pamphlet if:
137(1) the patient is receiving outpatient palliative care pursuant to section 227 of chapter 111; (2)
138the patient is a resident of a long-term care facility; or (3) the narcotic or controlled substance is
139prescribed for use in the treatment of substance use disorder or opioid dependence. For the
140purposes of this section, non-opioid treatment alternatives shall include, but shall not be limited
141to, medications, restorative therapies, interventional procedures, behavioral health approaches
142and complementary and integrative treatments.
143 SECTION 7. Said chapter 94C is hereby further amended by inserting after section 34A
144the following section:-
145 Section 34A½. (a) As used in this section, the following words shall, unless the context
146clearly requires otherwise, have the following meanings: 8 of 51
147 “Drug testing services”, the use of testing equipment to identify or analyze the strength,
148effectiveness or purity of a controlled substance to determine whether the controlled substance
149contains chemicals, toxic substances or hazardous compounds prior to its injection, inhalation or
150ingestion by another person.
151 “Testing equipment”, including, but not limited to: fentanyl test strips, colorimetric
152reagents, high-performance liquid chromatography, gas chromatography and mass spectrometry.
153 (b)(1) A person acting in good faith and within the scope of such person’s role providing
154or assisting in the provision of harm reduction services as an owner, employee, intern, volunteer
155or third-party contractor of an entity providing harm reduction services may provide or assist in
156the provision of drug testing services to an individual to ensure that a controlled substance in the
157possession of the individual and exclusively for that individual’s personal use does not contain
158dangerous chemicals, toxic substances or hazardous compounds likely to cause an accidental
159overdose.
160 (2) A person acting in good faith and within the scope of such person’s role providing or
161assisting in the provision of harm reduction services as an owner, employee, intern, volunteer or
162third-party contractor of an entity providing harm reduction services who provides or assists in
163the provision of drug testing services pursuant to this section shall not be charged or prosecuted
164pursuant to sections 32I, 34 or 40.
165 (3) A person acting in good faith and within the scope of such person’s role providing or
166assisting in the provision of harm reduction services as an owner, employee, intern, volunteer or
167third-party contractor of an entity providing harm reduction services who provides or assists in
168the provision of drug testing services pursuant to this section shall not be subject to any criminal 9 of 51
169or civil liability or any professional disciplinary action as a result of any act or omission related
170to the provision of drug testing services; provided, however, that this paragraph shall not apply to
171acts or omissions of gross negligence or willful or wanton misconduct.
172 (c) An individual acting in good faith who seeks drug testing services of a controlled
173substance in such individual’s possession and intended exclusively for such individual’s personal
174use from a person acting in good faith and within the scope of the person’s role providing or
175assisting in the provision of harm reduction services as an owner, employee, intern, volunteer or
176third-party contractor of an entity providing harm reduction services shall not be charged or
177prosecuted pursuant to sections 32I, 34 or 40 while on the premises where the drug testing
178services are conducted.
179 SECTION 8. Section 25J½ of chapter 111 of the General Laws, as appearing in the 2022
180Official Edition, is hereby amended by inserting after the first paragraph the following
181paragraph:-
182 Upon discharge of a patient from an acute care hospital, a satellite emergency facility or a
183freestanding psychiatric hospital who has: (i) a history of or is actively using opioids; (ii) been
184diagnosed with opioid use disorder; or (iii) experienced an opioid-related overdose, the acute
185care hospital, satellite emergency facility or freestanding psychiatric hospital shall educate the
186patient on the use of opioid antagonists, as defined in section 19B of chapter 94C, and prescribe
187or dispense not less than 2 doses of an opioid antagonist to the patient or a legal guardian of the
188patient.
189 SECTION 9. Said chapter 111 is hereby further amended by inserting after section 110C
190the following 2 sections:- 10 of 51
191 Section 110D. (a) The department shall collect and provide data to the department of
192children and families on all births of infants affected by prenatal substance exposure in a form
193and manner consistent with any requirements of the federal Child Abuse Prevention and
194Treatment Act, 42 U.S.C. § 5101 et seq. and 42 U.S.C. § 5116 et seq.
195 (b) Annually, not later than April 1, the department, in consultation with the department
196of children and families and the office of the child advocate, shall file with the clerks of the
197house of representatives and the senate, the house and senate committees on ways and means, the
198joint committee on children, families and person with disabilities and the joint committee on
199mental health, substance use and recovery a report, along with any recommendations, examining
200the prevalence of births of infants identified as affected by prenatal substance exposure or fetal
201alcohol spectrum disorder, including, but not limited to: (i) any gaps in services for perinatal
202patients or such infants; (ii) an examination of child abuse and neglect reports related to an
203infant’s prenatal exposure to substances, including those that were ultimately screened out by the
204department of children and families; (iii) an examination of child abuse and neglect reports made
205pursuant to section 51A of chapter 119 related to an infant’s prenatal exposure to substances; and
206(iv) any recommended changes, including legislative or regulatory changes, that may be
207necessary to ensure the ongoing health, safety and wellbeing of perinatal patients and infants. If
208applicable, the department, in consultation with the department of children and families and the
209office of the child advocate, shall provide recommendations to address disparate impacts on the
210safety and wellbeing of infants identified as affected by prenatal substance exposure or fetal
211alcohol spectrum disorder.
212 Section 110E. (a) The department, in consultation with the department of children and
213families and the office of the child advocate, shall promulgate regulations on the requirements of 11 of 51
214health care providers involved in the delivery or care of infants identified as being affected by
215prenatal substance exposure or fetal alcohol spectrum disorder. The regulations shall cover topics
216including, but not limited to: (i) assessment for prenatal substance exposure and fetal alcohol
217spectrum disorder; (ii) assessment for prenatal substance exposure from a medication prescribed
218by a licensed health care provider; and (iii) the roles and responsibilities of health care providers
219and staff who care for perinatal patients or infants in relation to the requirements of 42 U.S.C. §
2205106a(b)(2)(B)(ii) and in accordance with the federal Child Abuse Prevention and Treatment
221Act, 42 U.S.C. § 5101 et seq. and 42 U.S.C. § 5116 et seq., including, but not limited to, the
222development and implementation of plans of safe care, if indicated, and referrals for appropriate
223services.
224 (b) Such regulations may: (i) reflect current accepted standards of health care and
225substance use treatment practices; (ii) enable data collection in a form and manner consistent
226with the reporting requirements under the federal Child Abuse Prevention and Treatment Act, 42
227U.S.C. § 5101 et seq. and 42 U.S.C. § 5116 et seq.; and (iii) to the extent possible, enable data
228collection regarding racial disparities in maternal and child health care, the number of patients
229identified for plans of safe care and appropriate service referrals pursuant to the federal Child
230Abuse Prevention and Treatment Act, 42 U.S.C. § 5101 et seq. and 42 U.S.C. § 5116 et seq.
231 (c) Such regulations shall be developed with input from relevant stakeholders, including,
232but not limited to: (i) medical professional associations and health care providers with expertise
233in the provision of care to pregnant people; (ii) individuals who have lived experience of seeking
234or receiving behavioral health services or treatment prior to, during and after pregnancy; (iii)
235professional associations and organizations with expertise in prenatal substance exposure,
236perinatal and child health, treatment of substance use disorder and racial equity in access to 12 of 51
237health care; and (iv) behavioral health professionals with expertise in providing culturally-
238competent care.
239 SECTION 10. Section 7 of chapter 111E of the General Laws, as appearing in the 2022
240Official Edition, is hereby amended by inserting after the word “basis”, in line 28, the following
241words:- , as determined by the department to be consistent with section 4 of chapter 151B and
242sufficient to ensure the needs of such residents are met and such residents have adequate access
243to such a facility.
244 SECTION 11. The General Laws are hereby amended by striking out chapter 111J, as so
245appearing, and inserting in place thereof the following chapter:-
246 CHAPTER 111J.
247 ALCOHOL AND DRUG COUNSELORS; RECOVERY COACHES.
248 Section 1. As used in this chapter, the following words shall, unless the context clearly
249requires otherwise, have the following meanings:
250 “Applicant”, an individual seeking licensure under this chapter.
251 “Approved continuing education”, continuing education approved by the department,
252including research and training programs, college and university courses, in-service training
253programs, seminars and conferences, designed to maintain and enhance the skills of licensees.
254 “Approved program”, a program approved by the department for the education and
255training of applicants. 13 of 51
256 “Approved recovery coach supervisor”, a licensed recovery coach who has completed
257recovery coach supervision training that has been approved by the department.
258 “Approved work experience”, supervised work experience, approved by the department,
259in the practice area for which an applicant seeks licensure.
260 “Department”, the department of public health.
261 “Licensee”, an individual who is licensed under this chapter.
262 “Licensed alcohol and drug counselor I”, a person licensed by the department to conduct
263an independent practice of alcohol and drug counseling and to provide supervision to other
264alcohol and drug counselors; provided, however, that a licensed alcohol and drug counselor I
265shall have: (i) received a master’s or doctoral degree in behavioral sciences, which included a
266supervised counseling practicum that meets the requirements established by the department or
267such equivalent educational credits as may be established by the department; (ii) not less than 3
268years of approved work experience; and (iii) passed a licensing examination approved by the
269department.
270 “Licensed alcohol and drug counselor II”, a person licensed by the department to practice
271alcohol and drug counseling under clinical supervision; provided, however, that a licensed
272alcohol and drug counselor II shall have: (i) completed an approved program of education, which
273included a supervised counseling practicum that meets the requirements established by the
274department or such equivalent educational credits as may be established by the department; (ii)
275not less than 3 years of approved work experience; and (iii) passed a licensing examination
276approved by the department. 14 of 51
277 “Licensed recovery coach”, a person with lived experience who is licensed by the
278department to practice recovery coaching using shared understanding, respect and mutual
279empowerment to help others become and stay engaged in the process of recovery from a
280substance use disorder; provided, however, that a licensed recovery coach shall: (i) have
281completed an approved program of education, including approved work experience that meets
282the requirements established by the department; (ii) demonstrate not less than 2 years of
283sustained recovery; and (iii) have met all education, training and experience requirements and
284qualifications as established by the department.
285 “Lived experience”, the experience of addiction and recovery from a substance use
286disorder.
287 Section 2. (a) The department shall establish and administer a program for the licensure
288of alcohol and drug counselors and recovery coaches. The department shall: (i) establish the
289licensure requirements for licensed alcohol and drug counselors practicing in the commonwealth;
290(ii) establish the licensure requirements for licensed recovery coaches practicing in the
291commonwealth; (iii) evaluate the qualifications of applicants for licensure; (iv) supervise
292licensing examinations, where applicable; (v) establish and collect fees for licensing and
293examination, where applicable; (vi) grant and issue licenses to applicants who satisfy the
294department’s requirements for licensure; (vii) establish continuing education requirements; (viii)
295investigate complaints; (ix) take appropriate disciplinary action to protect the public health,
296safety and welfare; and (x) perform other functions and duties as may be necessary to carry out
297this chapter. 15 of 51
298 (b) The department shall establish requirements for licensed alcohol and drug counselors
299I and licensed alcohol and drug counselors II and may establish other reasonable classifications
300for alcohol and drug counselors as it finds necessary and appropriate, including, but not limited
301to, alcohol and drug counselors specializing in youth recovery counseling, taking into
302consideration different levels of education, training and work experience.
303 (c) The department shall establish requirements for licensed recovery coaches, including,
304but not limited to, establishing an ethical code of conduct for recovery coaches, and may
305establish other reasonable classifications for recovery coaches as it finds necessary and
306appropriate, taking into consideration different levels of education, training and work experience.
307 (d) The department shall approve and issue certificates of approval of programs for the
308training of alcohol and drug counselors. The department shall maintain a list of approved
309programs and a current roster of persons serving as licensed alcohol and drug counselors in the
310commonwealth.
311 (e) The department shall approve and issue certificates of approval of programs for the
312training of recovery coaches. The department shall maintain a list of approved programs and a
313current roster of persons serving as licensed recovery coaches in the commonwealth.
314 (f) The department shall promulgate rules and regulations to implement this chapter,
315including, but not limited to, rules and regulations establishing the educational and professional
316requirements for licensing individuals under this chapter, establishing fees for licensing and
317examination, where applicable, and governing the practice and employment of licensees to
318promote the public health, safety and welfare. 16 of 51
319 Section 3. (a) Each applicant shall furnish the department with proof of satisfactory
320completion of the educational, training and experience requirements for licensure, including
321completion of an approved program and approved work experience and proof of having passed
322any licensing examinations required by the department; provided, however, that the department
323may establish additional requirements for licensure and exemptions by regulation.
324 (b) A license under this chapter shall be valid for a 2-year period and licensees may apply
325for renewal of a license for a like term. A licensee seeking license renewal shall submit proof of
326having successfully completed the requirements for approved continuing education as may be
327established by the department.
328 (c) Applications for licenses and renewals thereof shall be submitted in accordance with
329procedures established by the department. The department may establish fees for license
330applications and renewals.
331 Section 4. (a) Except as otherwise provided in this chapter or by regulation, a person not
332licensed or otherwise exempt from licensing shall not hold themself out as a licensed recovery
333coach and shall not use the title, initials, abbreviations, insignia or description of a licensed
334recovery coach or practice or attempt to practice recovery coaching unless otherwise authorized
335by law or rule or regulation of the department. Whoever engages in any such unauthorized action
336shall be subject to a fine of not less than $500. The department may bring a petition in superior
337court to enjoin such action or any other violation of this chapter or a regulation hereunder.
338 (b) Individuals working under an approved recovery coach supervisor and receiving
339approved work experience may practice without a license in order to obtain the requisite hours of
340supervised experience needed to obtain a recovery coach license; provided, however, that such 17 of 51
341individuals shall meet all other requirements for recovery coach applicants provided for in this
342chapter or by regulation.
343 (c) Nothing in this section shall prevent members of peer groups or self-help groups from
344performing peer support or self-help activities that may be included within the practice of
345recovery coaching; provided, however, that no members of peer groups or self-help groups who
346are not so credentialed shall use a title stating or implying that such person is a licensed recovery
347coach.
348 Section 5. (a) Except as otherwise provided for in this chapter or by regulation, a person
349who is not licensed or is otherwise exempt from licensing shall not hold themself out as a
350licensed alcohol and drug counselor and shall not use the title, initials or description of a licensed
351alcohol and drug counselor or practice or attempt to practice alcohol and drug counseling.
352Whoever engages in any such unauthorized action shall be subject to a fine of not less than $500.
353The department may bring a petition in superior court to enjoin such unauthorized action or any
354other violation of this chapter or a regulation hereunder.
355 (b) The following individuals shall be exempt from the licensing requirements for alcohol
356and drug counseling under this chapter:
357 (i) an educational psychologist, marriage and family therapist, mental health counselor,
358nurse practitioner, occupational therapist, physician, physician assistant, practical nurse,
359psychologist, registered nurse, rehabilitation counselor or social worker;
360 (ii) an employee or other agent of a recognized academic institution or employee
361assistance program, a federal, state, county or local government institution, program, agency or
362facility or school committee, school district, school board or board of regents while performing 18 of 51
363alcohol and drug counseling duties solely for the respective entity or under the jurisdiction of
364such entity; provided, however, that a license pursuant to this chapter need not be a requirement
365for employment in any state, county or municipal agency; and
366 (iii) an employee of a treatment program or facility licensed or approved by the
367department pursuant to chapters 111B and 111E; provided, however, that such individual shall
368perform alcohol and drug counseling solely within or under the jurisdiction of such program or
369facility.
370 (c) Nothing in this section shall prevent qualified members of other professions,
371including attorneys, Christian Science practitioners or members of the clergy, from providing
372alcohol or drug counseling consistent with accepted standards of their respective professions;
373provided, however, that no such person shall use a title stating or implying that such person is a
374licensed alcohol and drug counselor.
375 (d) Nothing in this section shall prevent members of peer groups or self-help groups from
376performing peer group or self-help activities; provided, however, that no such person shall use a
377title stating or implying that such person is a licensed alcohol and drug counselor.
378 Section 6. (a) The department shall establish procedures for consumers to file written
379complaints regarding licensees. The department shall investigate all complaints relating to the
380proper practice of a licensee under this chapter and all complaints relating to any violation of this
381chapter or regulation promulgated hereunder.
382 (b) The department may conduct an adjudicatory proceeding pursuant to chapter 30A but
383shall not issue, vacate, modify or enforce subpoenas pursuant to section 12 of said chapter 30A.
384The department may, after a hearing pursuant to said chapter 30A, deny, refuse renewal, revoke, 19 of 51
385limit or suspend a license or otherwise discipline a licensee; provided, however, that the
386department may suspend the license of a licensee who poses an imminent danger to the public
387without a hearing; provided further, that the licensee shall be afforded a hearing within 7
388business days of receipt of a notice of such denial, refusal to renew, revocation, limitation,
389suspension or other disciplinary action; and provided further, that the department shall conduct
390its proceedings in accordance with the provisions of this chapter and said chapter 30A. Grounds
391for denial, refusal to renew, revocation, limitation, suspension or other discipline shall include:
392(i) fraud or misrepresentation in obtaining a license; (ii) criminal conduct which the department
393determines to be of such a nature as to render such person unfit to practice as evidenced by
394criminal proceedings resulting in a conviction, guilty plea or plea of nolo contendere or an
395admission of sufficient facts; (iii) violation of any law or rule or regulation of the department
396governing the practice of the licensee under this chapter; (iv) violation of ethical standards which
397the department determines to be of such a nature as to render such person unfit to practice as a
398licensee; or (v) other just and sufficient cause that the department determines would render a
399person unfit to practice as a licensee.
400 (c) Where denial, refusal to renew, revocation or suspension is based solely on the failure
401of the licensee to timely file an application or pay prescribed fees or to maintain insurance
402coverage as required by applicable law or regulation, the department may act without first
403granting the applicant or licensee a hearing.
404 Section 7. Examinations for licensure, where applicable, shall be conducted not less than
405twice per year at times and places and in formats designated by the department. Examinations for
406licensure, where applicable, shall be written; provided, however, that portions thereof may be 20 of 51
407conducted orally at the department’s discretion; and provided further, that a person who fails an
408examination may be admitted to the next available examination.
409 Section 8. (a) The department may issue a license without examination to an applicant
410who meets the requirements for licensure established by the department if such applicant is
411licensed or certified in alcohol and drug counseling or in recovering coaching or a comparable
412field in another state wherein the requirements for licensure shall be determined by the
413department to be equivalent to or in excess of the requirements of this chapter.
414 (b) The department shall promulgate rules and regulations as may be necessary to
415implement this section.
416 Section 9. The bureau of substance addiction services within the department shall
417establish a comprehensive peer support program to provide mentorship, technical assistance and
418resources to support the skill-building and credentialing of peers working in substance addiction
419recovery services, including, but not limited to, peer workers and recovery coaches. The program
420shall include, but shall not be limited to: (i) a network for peer-to-peer trainings, education,
421mentorship, counseling and support; (ii) educational and other support materials; (iii) technical
422assistance for licensure, certification, credentialing and other employment and practice
423requirements; and (iv) billing technical assistance for organizations that employ recovery
424coaches. The bureau shall consult peers working in substance addiction recovery services in the
425establishment of such comprehensive peer support program.
426 SECTION 12. Chapter 112 of the General Laws is hereby amended by inserting after
427section 52G the following section:- 21 of 51
428 Section 52H. (a) For the purpose of this section, the following words shall, unless the
429context clearly requires otherwise, have the following meanings:
430 “Board”, the board of registration in dentistry established in section 19 of chapter 13.
431 “Unified recovery and monitoring program” or “Program”, the program for monitoring
432the rehabilitation of licensed health care professionals established by the department pursuant to
433section 65G.
434 (b)(1) The board shall participate in the unified recovery and monitoring program and
435shall make appropriate referrals to said unified recovery and monitoring program of dentists and
436dental hygienists who seek support for their mental health or substance use as a voluntary
437alternative to disciplinary actions.
438 (2) The board shall: (i) establish criteria for the referral of registered dentists and dental
439hygienists; (ii) establish an outreach program to identify registered dentists and dental hygienists
440who may have a qualifying mental health condition or substance use disorder; and (iii) provide
441education about the program to promote early identification, intervention, evaluation and
442monitoring; provided, however, that the outreach program required under this paragraph shall
443notify dentists and dental hygienists of the opportunity to apply directly with the department to
444participate in the program.
445 (c) A registered dentist or dental hygienist who requests to participate in the program
446shall cooperate with the individualized rehabilitation plan recommended by the program. The
447program director employed pursuant to subsection (e) of section 65G may report to the board: (i)
448information concerning a participant in the program; (ii) aggregate data on program compliance; 22 of 51
449and (iii) the name and license number of a registered dentist or dental hygienist who fails to
450comply with an individualized remediation plan.
451 (d) Upon admission of a dentist or dental hygienist into the program, the board may
452dismiss any pending investigation or complaint against the participant that arises from or relates
453to the participant’s mental health or substance use. The board may change the participant’s
454publicly-available license status to reflect the existence of non-disciplinary restrictions or
455conditions. The board may immediately suspend the participant’s license as is necessary to
456protect the public health, safety and welfare upon receipt of notice that the participant has
457withdrawn or been terminated from the program before completion.
458 (e) The record of participation in the program shall not be a public record and shall be
459exempt from disclosure pursuant to clause Twenty-sixth of section 7 of chapter 4 and chapter 66.
460If a dentist or dental hygienist referred to the program by the board fails to complete the
461application process, the board may use information and documents in the record of participation
462as evidence in a disciplinary proceeding as necessary to protect public health, safety and welfare.
463In all other instances, the record of participation or application to the program shall be kept
464confidential and shall not be subject to subpoena or discovery in any civil, criminal, legislative or
465administrative proceeding without the prior written consent of the participant or applicant. Upon
466the determination by the rehabilitation evaluation committee established pursuant section 65G
467that a participant has successfully completed the program and their ability to safely practice their
468profession is not impaired or affected by their mental health or substance use, the department, the
469program, the rehabilitation evaluation committee and the board, if applicable, shall seal all
470records pertaining to the participant's participation in the program. The records of participation of 23 of 51
471participants who successfully complete the program shall be destroyed 3 years following the date
472of successful completion.
473 SECTION 13. Said chapter 112 is hereby further amended by inserting after section 162
474the following section:-
475 Section 162A. (a) For the purposes of this section, the following words shall, unless the
476context clearly requires otherwise, have the following meanings:
477 “Acupuncture detoxification specialist”, a qualified health care professional who is
478registered with the department to engage in the practice of auricular acupuncture detoxification
479pursuant to this section.
480 “Auricular acupuncture detoxification”, treatment by means of the subcutaneous insertion
481of sterile, disposable acupuncture needles in consistent, predetermined bilateral locations on the
482ear in accordance with the standardized auricular acupuncture detoxification protocol developed
483by the National Acupuncture Detoxification Association.
484 “General supervision”, supervision by phone or other electronic means during business
485hours with in-person site visits as deemed necessary by a licensed acupuncturist.
486 “Licensed acupuncturist”, an individual who is licensed under sections 148 to 162,
487inclusive, to practice as a licensed acupuncturist.
488 “National Acupuncture Detoxification Association training”, the most current
489standardized auricular acupuncture detoxification protocol training developed by the National
490Acupuncture Detoxification Association. 24 of 51
491 “Qualified health care professional”, a qualified individual who: (i) is a licensed
492physician, licensed psychologist, licensed independent clinical social worker, licensed clinical
493social worker, licensed mental health counselor, licensed psychiatric clinical nurse specialist,
494certified addictions registered nurse, licensed alcohol and drug counselor I or licensed alcohol
495and drug counselor II as defined in section 1 of chapter 111J, certified alcohol and drug abuse
496counselor or certified alcohol and drug abuse counselor II as certified by the Massachusetts
497Board of Substance Abuse Counselor Certification or an equivalent certifying body or a
498registered nurse or nurse practitioner certified by the board of registration in nursing pursuant to
499this chapter; and (ii) has received training and a certificate of completion from the National
500Acupuncture Detoxification Association or from a state-recognized organization or agency that
501meets or exceeds the National Acupuncture Detoxification Association training standards to
502engage in the practice of auricular acupuncture detoxification protocol for the treatment of
503substance use disorder, mental and behavioral health conditions and trauma.
504 (b)(1) An individual who is not a licensed acupuncturist shall not engage in the practice
505of the auricular acupuncture detoxification or represent themself as an acupuncture detoxification
506specialist unless the individual: (i) has been issued: (A) an approved registration by the
507department to practice auricular acupuncture detoxification in accordance with this section; or
508(B) a license or certificate in another state with requirements that are at least equivalent to the
509requirements of this section, as determined by the commissioner; and (ii) has been trained in the
510standardized auricular acupuncture detoxification protocol in accordance with the National
511Acupuncture Detoxification Association training or an equivalent training certificate by a state-
512recognized organization. 25 of 51
513 (2) To engage in the practice of auricular acupuncture detoxification within the
514individual’s designated lawful scope of practice, a qualified health care professional shall file an
515application to register as an acupuncture detoxification specialist with the department, in a form
516determined by the department. Each application may be accompanied by the payment of a fee to
517be determined by the department.
518 (3) The applicant seeking to practice auricular acupuncture detoxification shall, at a
519minimum, furnish proof of: (i) relevant licensure or certification as a qualified health care
520professional; and (ii) completion of the National Acupuncture Detoxification Association
521training or an equivalent training certificate by a state-recognized organization; provided,
522however, that an applicant who is registered or certified in another state with requirements that
523are at least equivalent to the requirements of this section, as determined by the commissioner,
524shall be allowed to practice auricular acupuncture detoxification in accordance with this section.
525A registration issued under this section shall be valid for 2 years and subject to renewal as
526determined by the department.
527 (c) Auricular acupuncture detoxification shall only be performed by a licensed
528acupuncturist or a qualified health care professional within their designated lawful scope of
529practice for the purpose of providing integrated health care delivery interventions in substance
530use disorder treatment and wellness promotion including, but not limited to, treating mental and
531behavioral health conditions or trauma.
532 (d) A qualified health care professional registered in accordance with this section shall
533only practice under the general supervision of a licensed acupuncturist; provided, however, that
534no such individual shall use the title acupuncturist or otherwise represent themself or imply that 26 of 51
535they are a licensed acupuncturist and shall not perform or practice acupuncture outside of the
536scope of the auricular acupuncture detoxification as defined in this section.
537 (e) Nothing in this chapter shall prohibit, limit, interfere with or prevent a qualified health
538care professional from practicing or performing auricular acupuncture detoxification if the
539individual is acting within the lawful scope of practice in accordance with the individual’s
540license and the auricular acupuncture detoxification is performed in: (i) a private, freestanding
541facility licensed by the department that provides care or treatment for individuals with substance
542use disorders or other addictive disorders; (ii) a facility under the direction and supervision of the
543department of mental health; (iii) a setting approved or licensed by the department of mental
544health; or (iv) any other setting where auricular acupuncture detoxification is an appropriate
545adjunct therapy to a substance use disorder or behavioral health treatment program; provided,
546however, that individual or 1-on-1 appointments with a health care provider shall occur within a
547setting permissible under this subsection.
548 (f) Nothing in this chapter shall prohibit, limit, interfere with or prevent a licensed
549physician or acupuncturist from practicing or performing auricular acupuncture detoxification if
550the licensed physician or acupuncturist is acting within the lawful scope of practice in
551accordance with their license.
552 (g) The commissioner may promulgate regulations to implement this section.
553 SECTION 14. Chapter 118E of the General Laws is hereby amended by inserting after
554section 10W the following 2 sections:-
555 Section 10X. (a) The division and its contracted health insurers, health plans, health
556maintenance organizations, behavioral health management firms and third-party administrators 27 of 51
557under contract to a Medicaid managed care organization, accountable care organization or
558primary care clinician plan shall provide coverage for prescribed, ordered or dispensed opioid
559antagonists, as defined in section 19B of chapter 94C and used in the reversal of overdoses
560caused by opioids; provided, however, that the coverage for such prescribed, ordered or
561dispensed opioid antagonists shall not require prior authorization; and provided further, that a
562prescription from a health care practitioner shall not be required for coverage or reimbursement
563of opioid antagonists under this section. An opioid antagonist used in the reversal of overdoses
564caused by opioids shall not be subject to any deductible, coinsurance, copayments or out-of-
565pocket limits.
566 (b) The division and its contracted health insurers, health plans, health maintenance
567organizations, behavioral health management firms and third-party administrators under contract
568to a Medicaid managed care organization, accountable care organization or primary care
569clinician plan shall provide coverage and reimbursement for an opioid antagonist used in the
570reversal of overdoses caused by opioids as a medical benefit when dispensed by the health care
571facility in which the opioid antagonist was prescribed or ordered and shall provide coverage as a
572pharmacy benefit for an opioid antagonist used in the reversal of overdoses caused by opioids
573dispensed by a pharmacist, including an opioid antagonist dispensed pursuant to section 19B of
574chapter 94C; provided, however, that the rate to be reimbursed under the medical benefit shall
575not exceed the carrier’s average in-network pharmacy benefit rate and the health care facility
576shall not balance bill the patient.
577 Section 10Y. The division and its contracted health insurers, health plans, health
578maintenance organizations, behavioral health management firms and third-party administrators
579under contract to a Medicaid managed care organization, accountable care organization or 28 of 51
580primary care clinician plan shall provide coverage for the provision of services by a recovery
581coach licensed or otherwise authorized to practice pursuant to chapter 111J, regardless of the
582setting in which these services are provided; provided, however, that such services shall be
583within the lawful scope of practice of a recovery coach. The benefits in this section shall not be
584subject to any deductible, coinsurance, copayments or out-of-pocket limits. Recovery coach
585services shall not require prior authorization.
586 SECTION 15. Subsection (a) of section 51A of chapter 119 of the General Laws, as
587appearing in the 2022 Official Edition, is hereby amended by striking out the first paragraph and
588inserting in place thereof the following paragraph:-
589 A mandated reporter shall immediately communicate with the department orally and
590shall, within 48 hours, file a written report with the department detailing suspected abuse or
591neglect if, in their professional capacity, they have reasonable cause to believe that a child is: (i)
592suffering physical or emotional injury resulting from abuse inflicted upon them which causes
593harm or substantial risk of harm to the child’s health or welfare including, but not limited to,
594sexual abuse; (ii) suffering physical or emotional injury resulting from neglect including, but not
595limited to, malnutrition; (iii) a sexually exploited child; or (iv) a human trafficking victim, as
596defined by section 20M of chapter 233; provided, however, that an indication of prenatal
597substance exposure shall not solely meet the requirements of this section.
598 SECTION 16. Section 35 of chapter 123 of the General Laws, as so appearing, is hereby
599amended by inserting after the definition of “Facility” the following definition:-
600 “Secure facility”, a facility that provides care and treatment for a person with alcohol or
601substance use disorder funded, controlled or administered by a county sheriff or a facility so 29 of 51
602designated by the department of public health or the department of mental health that provides a
603comparable level of security.
604 SECTION 17. Said section 35 of said chapter 123, as so appearing, is hereby further
605amended by striking out the fourth to sixth paragraphs, inclusive, and inserting in place thereof
606the following 3 paragraphs:-
607 The secretary of health and human services shall ensure an adequate supply of suitable
608beds for the treatment of alcohol or substance use disorders at facilities licensed or approved by
609the department of public health or the department of mental health for persons ordered to be
610committed under this section.
611 If the department of public health informs the court that there are no suitable facilities
612available for treatment licensed or approved by the department of public health or the department
613of mental health, or if the court makes a specific finding that the only appropriate setting for
614treatment for the person is a secure facility, the person may be committed to a secure facility
615licensed or approved by the department of public health or the department of mental health;
616provided, however, that any person so committed shall be housed and treated separately from
617persons currently serving a criminal sentence.
618 A person committed under this section shall, upon release, be encouraged to consent to
619further treatment and shall be allowed voluntarily to remain in the facility or the secure facility
620for such purpose. The department of public health shall maintain a roster of facilities and secure
621facilities available, together with the number of beds currently available and the level of security
622at each facility, for the care and treatment of alcohol use disorder and substance use disorder and
623shall make the roster available to the trial court. 30 of 51
624 SECTION 18. Said section 35 of said chapter 123, as so appearing, is hereby further
625amended by inserting after the word “facility”, in line 133, the following words:- or secure
626facility.
627 SECTION 19. Section 1 of chapter 151B of the General Laws, as so appearing, is hereby
628amended by striking out subsection 17 and inserting in place thereof the following subsection:-
629 17. The term “handicap” means: (a) a physical or mental impairment which substantially
630limits 1 or more major life activities of a person; (b) a record of having such impairment; (c)
631being regarded as having such impairment; or (d) the lawful possession and clinically
632appropriate taking of any medication that is: (i) approved by the United States Food and Drug
633Administration for the treatment of an opioid-related substance use disorder, including, but not
634limited to, an opioid agonist or a partial opioid agonist and used for the treatment of an opioid-
635related substance use disorder; (ii) obtained directly or pursuant to a valid prescription or order
636from a practitioner, as defined in section 1 of chapter 94C; (iii) determined to be medically
637necessary by a practitioner while acting in the course of professional practice; and (iv) offered in
638accordance with a treatment plan that is reviewed by a practitioner at a frequency consistent with
639appropriate clinical standards; provided, however, that the term “handicap” shall not include
640current, illegal use of a controlled substance, as defined in said section 1 of said chapter 94C. For
641the purposes of this subsection, the words “clinically appropriate” shall mean the taking of a
642prescribed medication for the treatment of an opioid-related substance use disorder when such
643drug is medically indicated and intake is proportioned to the medical need.
644 SECTION 20. Chapter 175 of the General Laws is hereby amended by striking out
645section 47KK, as so appearing, and inserting in place thereof the following section:- 31 of 51
646 Section 47KK. (a) A policy, contract, agreement, plan or certificate of insurance issued,
647delivered or renewed within the commonwealth, which is considered creditable coverage under
648section 1 of chapter 111M, shall develop a plan to provide adequate coverage and access to a
649broad spectrum of pain management services, including, but not limited to, non-medication,
650nonsurgical treatment modalities and non-opioid medication treatment options that serve as
651alternatives to opioid prescribing, in accordance with guidelines developed by the division of
652insurance.
653 (b) No such policy, contract, agreement, plan or certificate of insurance shall, relative to
654pain management services identified by the carrier pursuant to subsection (a), require a member
655to obtain prior authorization for non-medication, nonsurgical treatment modalities that include
656restorative therapies, behavioral health approaches or integrative health therapies, including
657acupuncture, chiropractic treatments, massage and movement therapies.
658 (c)(1) The plan developed pursuant to subsection (a) shall be subject to approval by the
659division of insurance and shall be a component of carrier accreditation by the division pursuant
660to section 2 of chapter 176O. In its review, the division shall consider the adequacy of access to a
661broad spectrum of pain management services and any carrier policies that may create unduly
662preferential coverage to prescribing opioids without other pain management modalities.
663 (2) No policy, contract, agreement, plan or certificate of insurance issued, delivered or
664renewed within the commonwealth, which is considered creditable coverage under section 1 of
665chapter 111M, shall establish utilization controls, including prior authorization or step therapy
666requirements, for clinically appropriate non-opioid drugs approved by the United States Food
667and Drug Administration for the treatment or management of pain, that are more restrictive or 32 of 51
668extensive than the least restrictive or extensive utilization controls applicable to any clinically
669appropriate opioid drug.
670 (d) Carriers shall annually distribute educational materials to providers within their
671networks and to members about the pain management access plans developed pursuant to
672subsection (a) and shall make information about the plans publicly available on their websites.
673 SECTION 21. Said chapter 175 is hereby further amended by inserting after section
67447ZZ the following 2 sections:-
675 Section 47AAA. (a) A policy, contract, agreement, plan or certificate of insurance issued,
676delivered or renewed within the commonwealth, which is considered creditable coverage under
677section 1 of chapter 111M, shall provide coverage for prescribed, ordered or dispensed opioid
678antagonists, as defined in section 19B of chapter 94C and used in the reversal of overdoses
679caused by opioids; provided, however, that the coverage for such prescribed, ordered or
680dispensed opioid antagonists shall not require prior authorization; and provided further, that a
681prescription from a health care practitioner shall not be required for coverage or reimbursement
682of opioid antagonists under this section. An opioid antagonist used in the reversal of overdoses
683caused by opioids shall not be subject to any deductible, coinsurance, copayments or out-of-
684pocket limits; provided, however, that cost-sharing shall be required if the applicable plan is
685governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result
686of the prohibition on cost-sharing for this service.
687 (b) The policy, contract, agreement, plan or certificate of insurance shall provide
688coverage and reimbursement for an opioid antagonist used in the reversal of overdoses caused by
689opioids as a medical benefit when dispensed by the health care facility in which the opioid 33 of 51
690antagonist was prescribed or ordered and shall provide coverage as a pharmacy benefit for an
691opioid antagonist used in the reversal of overdoses caused by opioids dispensed by a pharmacist,
692including an opioid antagonist dispensed pursuant to section 19B of chapter 94C; provided,
693however, that the rate to be reimbursed under the medical benefit shall not exceed the carrier’s
694average in-network pharmacy benefit rate and the health care facility shall not balance bill the
695patient.
696 Section 47BBB. A policy, contract, agreement, plan or certificate of insurance issued,
697delivered or renewed within the commonwealth, which is considered creditable coverage under
698section 1 of chapter 111M, shall provide coverage for the provision of services by a recovery
699coach licensed or otherwise authorized to practice under chapter 111J, regardless of the setting in
700which these services are provided; provided, however, that such services shall be within the
701lawful scope of practice of a recovery coach. The contractual rate for these services shall be not
702less than the prevailing MassHealth rate for recovery coach services. The benefits in this section
703shall not be subject to any deductible, coinsurance, copayments or out-of-pocket limits;
704provided, however, that cost-sharing shall be required if the applicable plan is governed by the
705federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition
706on cost-sharing for this service. Recovery coach services shall not require prior authorization.
707 SECTION 22. Said chapter 175 is hereby further amended by inserting after section
708122A the following section:-
709 Section 122B. (a) No insurer authorized to issue policies on the lives of persons in the
710commonwealth shall make a distinction or otherwise discriminate between persons, reject an
711applicant, cancel a policy or demand or require a higher rate of premium for reasons based solely 34 of 51
712upon the fact that an applicant or insured has or had a prescription for, purchased or otherwise
713possessed an opioid antagonist, as defined in section 19B of chapter 94C.
714 (b) A violation of this section shall constitute an unfair method of competition or unfair
715and deceptive act or practice pursuant to chapters 93A and 176D.
716 SECTION 23. Section 193U of said chapter 175, as appearing in the 2022 Official
717Edition, is hereby amended by inserting after the word “that”, in line 17, following words:- the
718health care provider provides services at a harm reduction program or.
719 SECTION 24. Chapter 176A of the General Laws is hereby amended by striking out
720section 8MM, as so appearing, and inserting in place thereof the following section:-
721 Section 8MM. (a) A contract between a subscriber and the corporation under an
722individual or group hospital service plan that is delivered, issued or renewed within the
723commonwealth shall develop a plan to provide adequate coverage and access to a broad
724spectrum of pain management services, including, but not limited to, non-medication,
725nonsurgical treatment modalities and non-opioid medication treatment options that serve as
726alternatives to opioid prescribing, in accordance with guidelines developed by the division of
727insurance.
728 (b) No such contract shall, relative to pain management services identified by the carrier
729pursuant to subsection (a), require a member to obtain prior authorization for non-medication,
730nonsurgical treatment modalities that include restorative therapies, behavioral health approaches
731or integrative health therapies, including acupuncture, chiropractic treatments, massage and
732movement therapies. 35 of 51
733 (c)(1) The plan developed pursuant to subsection (a) shall be subject to approval by the
734division of insurance and shall be a component of carrier accreditation by the division pursuant
735to section 2 of chapter 176O. In its review, the division shall consider the adequacy of access to a
736broad spectrum of pain management services and any carrier policies that may create unduly
737preferential coverage to prescribing opioids without other pain management modalities.
738 (2) No contract between a subscriber and the corporation under an individual or group
739hospital service plan that is delivered, issued or renewed within the commonwealth shall
740establish utilization controls, including prior authorization or step therapy requirements, for
741clinically appropriate non-opioid drugs approved by the United States Food and Drug
742Administration for the treatment or management of pain, that are more restrictive or extensive
743than the least restrictive or extensive utilization controls applicable to any clinically appropriate
744opioid drug.
745 (d) Carriers shall annually distribute educational materials to providers within their
746networks and to members about the pain management access plans developed pursuant to
747subsection (a) and shall make information about the plans publicly available on their websites.
748 SECTION 25. Said chapter 176A is hereby further amended by inserting after section
7498AAA the following 2 sections:-
750 Section 8BBB. (a) Any contract between a subscriber and the corporation under an
751individual or group hospital service plan that is delivered, issued or renewed within the
752commonwealth shall provide coverage for prescribed, ordered or dispensed opioid antagonists,
753as defined in section 19B of chapter 94C and used in the reversal of overdoses caused by
754opioids; provided, however, that the coverage for such prescribed, ordered or dispensed opioid 36 of 51
755antagonists shall not require prior authorization; and provided further, that a prescription from a
756health care practitioner shall not be required for coverage or reimbursement of opioid antagonists
757under this section. An opioid antagonist used in the reversal of overdoses caused by opioids shall
758not be subject to any deductible, coinsurance, copayments or out-of-pocket limits; provided,
759however, that cost-sharing shall be required if the applicable plan is governed by the federal
760Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on cost-
761sharing for this service.
762 (b) Such contracts shall provide coverage and reimbursement for an opioid antagonist
763used in the reversal of overdoses caused by opioids as a medical benefit when dispensed by the
764health care facility in which the opioid antagonist was prescribed or ordered and shall provide
765coverage as a pharmacy benefit for an opioid antagonist used in the reversal of overdoses caused
766by opioids dispensed by a pharmacist, including an opioid antagonist dispensed pursuant to
767section 19B of chapter 94C; provided, however, that the rate to be reimbursed under the medical
768benefit shall not exceed the carrier’s average in-network pharmacy benefit rate and the health
769care facility shall not balance bill the patient.
770 Section 8CCC. Any contract between a subscriber and the corporation under an
771individual or group hospital service plan that is delivered, issued or renewed within the
772commonwealth shall provide coverage for the provision of services by a recovery coach licensed
773or otherwise authorized to practice under chapter 111J, regardless of the setting in which these
774services are provided; provided, however, that such services shall be within the lawful scope of
775practice of a recovery coach. The contractual rate for these services shall be not less than the
776prevailing MassHealth rate for recovery coach services. The benefits in this section shall not be
777subject to any deductible, coinsurance, copayments or out-of-pocket limits; provided, however, 37 of 51
778that cost-sharing shall be required if the applicable plan is governed by the federal Internal
779Revenue Code and would lose its tax-exempt status as a result of the prohibition on cost-sharing
780for this service. Recovery coach services shall not require prior authorization.
781 SECTION 26. Chapter 176B of the General Laws is hereby amended by striking out
782section 4MM, as so appearing, and inserting in place thereof the following section:-
783 Section 4MM. (a) A subscription certificate under an individual or group medical service
784agreement delivered, issued or renewed within the commonwealth shall develop a plan to
785provide adequate coverage and access to a broad spectrum of pain management services,
786including, but not limited to, non-medication, nonsurgical treatment modalities and non-opioid
787medication treatment options that serve as alternatives to opioid prescribing, in accordance with
788guidelines developed by the division of insurance.
789 (b) No such subscription certificate shall, relative to pain management services identified
790by the carrier pursuant to subsection (a), require a member to obtain prior authorization for non-
791medication, nonsurgical treatment modalities that include restorative therapies, behavioral health
792approaches or integrative health therapies, including acupuncture, chiropractic treatments,
793massage and movement therapies.
794 (c)(1) The plan developed pursuant to subsection (a) shall be subject to approval by the
795division of insurance and shall be a component of carrier accreditation by the division pursuant
796to section 2 of chapter 176O. In its review, the division shall consider the adequacy of access to a
797broad spectrum of pain management services and any carrier policies that may create unduly
798preferential coverage to prescribing opioids without other pain management modalities. 38 of 51
799 (2) No subscription certificate under an individual or group medical service agreement
800delivered, issued or renewed within the commonwealth shall establish utilization controls,
801including prior authorization or step therapy requirements, for clinically appropriate non-opioid
802drugs approved by the United States Food and Drug Administration for the treatment or
803management of pain, that are more restrictive or extensive than the least restrictive or extensive
804utilization controls applicable to any clinically appropriate opioid drug.
805 (d) Carriers shall annually distribute educational materials to providers within their
806networks and to members about the pain management access plans developed pursuant to
807subsection (a) and shall make information about the plans publicly available on their websites.
808 SECTION 27. Said chapter 176B is hereby further amended by inserting after section
8094AAA the following 2 sections:-
810 Section 4BBB. (a) A subscription certificate under an individual or group medical service
811agreement delivered, issued or renewed within the commonwealth, shall provide coverage for
812prescribed, ordered or dispensed opioid antagonists, as defined in section 19B of chapter 94C
813and used in the reversal of overdoses caused by opioids; provided, however, that the coverage for
814such prescribed, ordered or dispensed opioid antagonists shall not require prior authorization;
815and provided further, that a prescription from a health care practitioner shall not be required for
816coverage or reimbursement of opioid antagonists under this section. An opioid antagonist used in
817the reversal of overdoses caused by opioids shall not be subject to any deductible, coinsurance,
818copayments or out-of-pocket limits; provided, however, that cost-sharing shall be required if the
819applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt
820status as a result of the prohibition on cost-sharing for this service. 39 of 51
821 (b) The policy, contract, agreement, plan or certificate of insurance shall provide
822coverage and reimbursement for an opioid antagonist used in the reversal of overdoses caused by
823opioids as a medical benefit when dispensed by the health care facility in which the opioid
824antagonist was prescribed or ordered and shall provide coverage as a pharmacy benefit for an
825opioid antagonist used in the reversal of overdoses caused by opioids dispensed by a pharmacist,
826including an opioid antagonist dispensed pursuant to section 19B of chapter 94C; provided,
827however, that the rate to be reimbursed under the medical benefit shall not exceed the carrier’s
828average in-network pharmacy benefit rate and the health care facility shall not balance bill the
829patient.
830 Section 4CCC. Any subscription certificate under an individual or group medical service
831agreement delivered, issued or renewed within the commonwealth shall provide coverage for the
832provision of services by a recovery coach licensed or otherwise authorized to practice under
833chapter 111J, regardless of the setting in which these services are provided; provided, however,
834that such services shall be within the lawful scope of practice of a recovery coach. The
835contractual rate for these services shall be not less than the prevailing MassHealth rate for
836recovery coach services. The benefits in this section shall not be subject to any deductible,
837coinsurance, copayments or out-of-pocket limits; provided, however, that cost-sharing shall be
838required if the applicable plan is governed by the federal Internal Revenue Code and would lose
839its tax-exempt status as a result of the prohibition on cost-sharing for this service. Recovery
840coach services shall not require prior authorization.
841 SECTION 28. Chapter 176G of the General Laws is hereby amended by striking out
842section 4EE, as appearing in the 2022 Official Edition, and inserting in place thereof the
843following section:- 40 of 51
844 Section 4EE. (a) Any individual or group health maintenance contract that is issued or
845renewed within or without the commonwealth shall develop a plan to provide adequate coverage
846and access to a broad spectrum of pain management services, including, but not limited to, non-
847medication, nonsurgical treatment modalities and non-opioid medication treatment options that
848serve as alternatives to opioid prescribing, in accordance with guidelines developed by the
849division of insurance.
850 (b) No such contract shall, relative to pain management services identified by the carrier
851pursuant to subsection (a), require a member to obtain prior authorization for non-medication,
852nonsurgical treatment modalities that include restorative therapies, behavioral health approaches
853or integrative health therapies, including acupuncture, chiropractic treatments, massage, and
854movement therapies.
855 (c)(1) The plan developed pursuant to subsection (a) shall be subject to approval by the
856division of insurance and shall be a component of carrier accreditation by the division pursuant
857to section 2 of chapter 176O. In its review, the division shall consider the adequacy of access to a
858broad spectrum of pain management services and any carrier policies that may create unduly
859preferential coverage to prescribing opioids without other pain management modalities.
860 (2) No individual or group health maintenance contract that is issued or renewed within
861or without the commonwealth shall establish utilization controls, including prior authorization or
862step therapy requirements, for clinically appropriate non-opioid drugs approved by the United
863States Food and Drug Administration for the treatment or management of pain, that are more
864restrictive or extensive than the least restrictive or extensive utilization controls applicable to any
865clinically appropriate opioid drug. 41 of 51
866 (d) Carriers shall annually distribute educational materials to providers within their
867networks and to members about the pain management access plans developed pursuant to
868subsection (a) and shall make information about the plans publicly available on their websites.
869 SECTION 29. Said chapter 176G is hereby further amended by inserting after section
8704SS the following 2 sections:-
871 Section 4TT. (a) An individual or group health maintenance contract that is issued or
872renewed within or without the commonwealth shall provide coverage for prescribed, ordered or
873dispensed opioid antagonists, as defined in section 19B of chapter 94C and used in the reversal
874of overdoses caused by opioids; provided, however, that the coverage for such prescribed,
875ordered or dispensed opioid antagonists shall not require prior authorization; and provided
876further, that a prescription from a health care practitioner shall not be required for coverage or
877reimbursement of opioid antagonists under this section. An opioid antagonist used in the reversal
878of overdoses caused by opioids shall not be subject to any deductible, coinsurance, copayments
879or out-of-pocket limits; provided, however, that cost-sharing shall be required if the applicable
880plan is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a
881result of the prohibition on cost-sharing for this service.
882 (b) The individual or group health maintenance contract shall provide coverage and
883reimbursement for an opioid antagonist used in the reversal of overdoses caused by opioids as a
884medical benefit when dispensed by the health care facility in which the opioid antagonist was
885prescribed or ordered and shall provide coverage as a pharmacy benefit for an opioid antagonist
886used in the reversal of overdoses caused by opioids dispensed by a pharmacist, including an
887opioid antagonist dispensed pursuant to section 19B of chapter 94C; provided, however, that the 42 of 51
888rate to be reimbursed under the medical benefit shall not exceed the carrier’s average in-network
889pharmacy benefit rate and the health care facility shall not balance bill the patient.
890 Section 4UU. An individual or group health maintenance contract that is issued or
891renewed within or without the commonwealth shall provide coverage for the provision of
892services by a recovery coach licensed or otherwise authorized to practice under chapter 111J,
893regardless of the setting in which these services are provided; provided, however, that such
894services shall be within the lawful scope of practice of a recovery coach. The contractual rate for
895these services shall be not less than the prevailing MassHealth rate for recovery coach services.
896The benefits in this section shall not be subject to any deductible, coinsurance, copayments or
897out-of-pocket limits; provided, however, that cost-sharing shall be required if the applicable plan
898is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result
899of the prohibition on cost-sharing for this service. Recovery coach services shall not require prior
900authorization.
901 SECTION 30. (a) Notwithstanding any general or special law to the contrary, the
902Massachusetts alcohol and substance abuse center, hereinafter referred to as the center, shall be
903considered a secure facility under section 35 of chapter 123 of the General Laws for the purposes
904of commitments under said section 35 of said chapter 123 until December 31, 2026 or such time
905as the secretary of health and human services determines there is an adequate supply of beds
906pursuant to subsection (b).
907 (b) The secretary of health and human services shall develop a plan to end operations at
908the center as a secure facility accepting persons committed for treatment for alcohol or substance
909use disorder by not later than December 31, 2026; provided, however, that persons may continue 43 of 51
910to be committed to the center until the department of public health or the department of mental
911health have identified, licensed or approved facilities with sufficient capacity to ensure an
912adequate supply of beds for the treatment of individuals committed under said section 35 of said
913chapter 123. In developing the plan, the secretary shall consider geographic distribution of
914facilities when identifying, licensing or approving facilities.
915 (c) The secretary shall submit the plan required under subsection (b) to the clerks of the
916senate and house of representatives and to the joint committee on mental health, substance use
917and recovery not later than 180 days after the effective date of this act. The secretary shall submit
918interim reports quarterly detailing the progress towards ending operations at the center to the
919clerks of the senate and house of representatives and to the joint committee on mental health,
920substance use and recovery. The quarterly reports shall include, but shall not be limited to the
921following: (i) a census of persons being treated at the center; (ii) the number of persons
922transferred from the center to other facilities licensed or approved by the department of public
923health or department of mental health; (iii) the location and bed capacity of each newly licensed
924or approved facility or existing facility that increases capacity; (iv) the type of facility and
925location of newly committed persons under section 35 of chapter 123 of the General Laws since
926the most recent quarterly report; and (v) the anticipated fiscal impact, if any, of complying with
927this section.
928 SECTION 31. (a) The department of public health shall study alcohol and drug free
929housing, as defined in section 18A of chapter 17 of the Generals Laws, commonly known as
930sober homes in the commonwealth, including the safety and recovery of sober home residents.
931The study shall include, but not be limited to: (i) appropriate training for operators and staff of
932sober homes and whether such training should be required; (ii) evidence-based methods for 44 of 51
933creating safe and health recovery environments; (iii) current oversight and additional oversight
934needed for sober homes; (iv) barriers to sober home facility improvements, including, but not
935limited to, fiscal constraints; and (v) different aspects, if any, between certified and noncertified
936sober homes. The department shall hold at least 1 public hearing as part of its study under this
937section.
938 (b) The department shall submit a report detailing the results of the study, along with
939recommendations and any proposed legislation necessary to carry out its recommendations, to
940the clerks of the senate and house of representatives, the joint committee on health care
941financing, the joint committee on public health, the joint committee on mental health, substance
942use and recovery and the senate and house committees on ways and means not later than July 31,
9432025.
944 SECTION 32. The bureau of substance addiction services within the department of
945public health shall conduct a comprehensive review of barriers to certification, credentialing and
946other employment and practice requirements of recovery coaches, including, but not limited to,
947peer support specialists, peer recovery coaches and recovery support navigators, and issue a
948report on its findings. The report shall include, but shall not be limited to: (i) cost barriers for
949individuals with lived experience as defined in section 1 of chapter 111J of the General Laws,
950including, but not limited to, application and examination fees for initial certification and
951credentialing; (ii) cost barriers to certification and credentialing renewals; (iii) cost and
952reimbursement barriers for hospitals and clinics licensed under chapter 111 of the General Laws
953and other employers to hire, train and retain recovery coaches, including, but not limited to, peer
954support specialists, peer recovery coaches and recovery support navigators; (iv) eligibility
955requirements for certification and credentialing; (v) access to training programs and resources; 45 of 51
956(vi) any additional barriers to obtaining and maintaining authorization to practice recovery
957coaching; and (vii) recommendations to address said barriers. The bureau shall submit a copy of
958the report to the secretary of health and human services, the clerks of the house of representatives
959and the senate and the joint committee on mental health, substance use and recovery within 90
960days after the effective date of this act.
961 SECTION 33. (a) The bureau of substance addiction services within the department of
962public health shall review and study the disparate impacts and disparities of substance use
963disorder, overdoses, overdose deaths and clinical outcomes for members of historically
964marginalized communities, including, but not limited to, impacts based on race, ethnicity,
965language, gender, gender identity, sexual orientation, age, disability and other social
966determinants of health as identified by the bureau.
967 (b) The bureau shall: (i) review current data and trends regarding substance use and
968overdose rates, disparities in treatment access and corresponding causes within historically
969marginalized communities; (ii) evaluate the effectiveness of current treatment interventions
970within historically marginalized communities; (iii) identify barriers to accessing treatment,
971including, but not limited to, access to necessary resources, education and access to appropriate
972care and interventions; and (iv) identify evidence-based strategies to reduce overdose deaths and
973improve access, treatment and education within historically marginalized communities.
974 (c) Not later than June 30, 2025, the bureau shall submit a report of its findings and any
975recommendations, including any legislative or regulatory changes that may be necessary to carry
976out such recommendations, to the clerks of the house of representatives and the senate, the joint 46 of 51
977committee on mental health, substance use and recovery and the joint committee on racial equity,
978civil rights, and inclusion.
979 SECTION 34. (a) For the purposes of this section, the words “administrative discharge”
980shall mean the termination of treatment of a patient determined by a health care provider to have
981a substance use disorder and related treatment needs despite a lack of clinical improvement in the
982patient due to a violation of an administrative rule of a licensed substance use disorder treatment
983program.
984 (b) The bureau of substance addiction services within the department of public health
985shall study the circumstances and effects of administrative discharges of patients from substance
986use disorder treatment programs licensed under sections 6 and 6A of chapter 111B of the
987General Laws or section 7 of chapter 111E of the General Laws or programs established
988pursuant to sections 24 and 24D of chapter 90 of the General Laws.
989 (c) The bureau shall examine: (i) standards used by substance use disorder treatment
990programs in determining when an administrative discharge is appropriate, including, but not
991limited to, any standard criteria, methodology or graduated sanctions based on staff and patient
992safety and the level of treatment and severity of the symptoms of the patient; (ii) options for
993patients following an administrative discharge from a substance use disorder treatment program,
994including, but not limited to, any programs or resources available to a patient and the frequency
995with which such options are provided to said patients; and (iii) the applicability, availability and
996effectiveness of regulations relative to the coordination of care and management of discharge
997planning for an administrative discharge pursuant to 105 CMR 164 and section 19 of chapter 17
998of the General Laws. 47 of 51
999 (d) Not later than December 31, 2025, the bureau shall submit its findings and any
1000recommendations, including any legislative or regulatory changes that may be necessary to
1001implement any recommendations, with the clerks of the house of representatives and senate, the
1002house and senate committees on ways and means and the joint committee on mental health,
1003substance use and recovery.
1004 SECTION 35. (a) The bureau of substance addiction services within the department of
1005public health shall conduct a study on the potential benefits of expanding collaborative practice
1006agreements between physicians and pharmacists to allow for the prescription of schedules II to
1007VI, inclusive, controlled substances by pharmacists outside of the hospital or other health care
1008setting to treat patients with substance use disorders.
1009 (b) The bureau shall study and report on: (i) collaborative practice agreements between
1010physicians and pharmacists for the prescription of substances in collaborative practice
1011agreements in other states; and (ii) the positive and negative impacts of allowing a collaborative
1012practice agreement for schedules II to VI, inclusive, controlled substances.
1013 (c) The bureau shall submit a report detailing the results of the study, along with its
1014recommendations and any proposed legislation necessary to carry out its recommendations, to
1015the clerks of the senate and house of representatives, the joint committee on mental health,
1016substance use and recovery, the joint committee on public health and the senate and house
1017committees on ways and means not later than June 30, 2025.
1018 SECTION 36. (a) There shall be a special commission to study and make
1019recommendations on ways to address the public health and safety concerns posed by the
1020proliferation of xylazine as an additive to illicit drugs, including, but not limited to, fentanyl. 48 of 51
1021 (b) The commission shall consist of: the chairs of the joint committee on mental health,
1022substance use and recovery, who shall serve as co-chairs; 1 member appointed by the speaker of
1023the house of representatives; 1 member appointed by the minority leader of the house of
1024representatives; 1 member appointed by the senate president; 1 member appointed by the
1025minority leader of the senate; the secretary of health and human services or a designee; the
1026commissioner of public health or a designee; the commissioner of mental health or a designee;
1027the secretary of public safety and security or a designee; 1 member who shall be a representative
1028of the bureau of substance addiction services within the department of public health; 1 member
1029who shall be a representative of the Massachusetts Veterinary Medical Association; and 1
1030member appointed by the governor who shall be a registered nurse or licensed physician with
1031experience in treating patients for substance use disorder.
1032 (c) The commission shall consider: (i) best practices to regulate and oversee the
1033production and distribution of xylazine to ensure that it is used solely for its intended purpose as
1034an animal tranquilizer administered by licensed veterinarians and not for human consumption;
1035(ii) whether xylazine should be classified as a controlled substance and appropriate penalties for
1036its illegal production and distribution; (iii) the availability of effective outreach and treatment
1037programs for patients who have been exposed to xylazine and ways to address any gaps in
1038available programs and services; and (iv) any other considerations determined to be relevant by
1039the commission.
1040 (d) The commission shall file a report and its recommendations, including any legislation
1041necessary to implement its recommendations, with the clerks of the house of representatives and
1042the senate not later than June 30, 2025. 49 of 51
1043 SECTION 37. (a) There shall be a special commission to study prescribing practices for
1044benzodiazepines and non-benzodiazepine hypnotics.
1045 (b) The commission shall meet not less than 4 times and shall invite the public and
1046medical experts in the field to offer testimony. The commission shall study and make
1047recommendations on topics including but not limited to: (i) current and best prescribing practices
1048for benzodiazepines and non-benzodiazepine hypnotics; (ii) proper labeling of benzodiazepines
1049and non-benzodiazepine hypnotics; and (iii) protocols to safely discontinue the use of
1050benzodiazepines and non-benzodiazepine hypnotics and minimize the patient’s symptoms of
1051withdrawal.
1052 (c) The commission shall consist of: the commissioner of public health or a designee,
1053who shall serve as chair; the secretary of health and human services or a designee; the director of
1054the bureau of substance addiction services or a designee; and 4 members to be appointed by the
1055governor, 1 of whom shall be a psychiatrist licensed to practice in the commonwealth, 1 of
1056whom shall be a representative from the Center for Addiction Medicine at Massachusetts
1057General Hospital, 1 of whom shall be a licensed clinician specializing in substance use disorder
1058and 1 of whom shall be an advocate from the substance use disorder treatment community.
1059 (d) The commission shall report its findings and recommendations, including any
1060proposed legislation, to the clerks of the senate and the house of representatives, the joint
1061committee on mental health, substance use and recovery and the senate and house committees on
1062ways and means not later than 1 year after the commission’s first meeting.
1063 SECTION 38. A Certified Addictions Recovery Coach certification issued by the
1064Massachusetts Board of Substance Abuse Counselor Certification or other comparable certifying 50 of 51
1065body shall serve as satisfactory proof for recovery coach application requirements, including test
1066exemptions, for a limited period following the effective date of this act as determined by the
1067department of public health; provided, however, that the department shall waive the lived
1068experience requirement for a recovery coach license pursuant to section 1 of chapter 111J of the
1069General Laws for an applicant who was credentialed by the Massachusetts Board of Substance
1070Abuse Counselor Certification prior to the effective date of this act. The eligible applicants shall
1071meet all other qualifications and requirements for licensure as determined by the department. The
1072department shall promulgate rules and regulations for the implementation of this section.
1073 SECTION 39. The plans required pursuant to section 17Q of chapter 32A of the General
1074Laws, amended by section 1; section 47KK of chapter 175 of the General Laws, amended by
1075section 20; section 8MM of chapter 176A of the General Laws, amended by section 24; section
10764MM of chapter 176B of the General Laws, amended by section 26; and section 4EE of chapter
1077176G of the General Laws, amended by section 28, shall be submitted to the division of
1078insurance by not later than May 1, 2025.
1079 SECTION 40. Not later than 18 months after the effective date of this act, the initial
1080report required pursuant to section 110D of chapter 111 of the General Laws shall be filed with
1081the clerks of the house of representatives and the senate, the house and senate committees on
1082ways and means, the joint committee on children, families and persons with disabilities and the
1083joint committee on mental health, substance use and recovery.
1084 SECTION 41. The department of public health shall promulgate regulations pursuant to
1085section 110E of chapter 111 of the General Laws not later than 60 days after the effective date of
1086this act. 51 of 51
1087 SECTION 42. The department of public health shall issue regulations pursuant to section
10888 of chapter 111J of the General Laws not later than 90 days after the effective date of this act.
1089 SECTION 43. No person shall be found to have violated section 4 of chapter 111J of the
1090General Laws until 6 months after the department of public health first establishes a recovery
1091coach license pursuant to section 2 of said chapter 111J.
1092 SECTION 44. All commission members pursuant to section 36 shall be appointed within
109330 days after the effective date of this act.
1094 SECTION 45. Section 17X of chapter 32A of the General Laws, section 10X of chapter
1095118E of the General Laws, section 47AAA of chapter 175 of the General Laws, section 8BBB of
1096chapter 176A of the General Laws, section 4BBB of chapter 176B of the General Laws, and
1097section 4TT of chapter 176G of the General Laws shall apply to all contracts entered into,
1098renewed or amended on or after July 1, 2025.
1099 SECTION 46. Section 17Y of chapter 32A of the General Laws, section 10Y of chapter
1100118E of the General Laws, section 47BBB of chapter 175 of the General Laws, section 8CCC of
1101chapter 176A of the General Laws, section 4CCC of chapter 176B of the General Laws, and
1102section 4UU of chapter 176G of the General Laws shall apply to all contracts entered into,
1103renewed or amended on or after January 1, 2026.
1104 SECTION 47. Sections 1, 20, 24, 26, and 28 shall apply to all contracts entered into,
1105renewed or amended on or after July 1, 2025.
1106 SECTION 48. Sections 5 and 8 shall take effect on July 1, 2025.