Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S2921 Compare Versions

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1	1	1 of 31
2	2	SENATE . . . . . . . . . . . . . . No. 2921
3	3	July 30, 2024 -- Text of the Senate amendment to the House Bill relative to accessing harm
4	4	reduction initiatives (House, No. 4758) (being the text of Senate, No. 2898, printed as amended)
5	5	The Commonwealth of Massachusetts
6	6	_______________
7	7	In the One Hundred and Ninety-Third General Court
8	8	(2023-2024)
9	9	_______________
10	10	1 SECTION 1. Chapter 32A of the General Laws is hereby amended by inserting after
11	11	2section 17S the following 2 sections:-
12	12	3 Section 17T. (a) Coverage offered by the commission to an active or retired employee of
13	13	4the commonwealth insured under the group insurance commission shall provide coverage for
14	14	5prescribed or dispensed opioid antagonists, as defined in section 19B of chapter 94C and used in
15	15	6the reversal of overdoses caused by opioids, which shall not require prior authorization;
16	16	7provided, however, that a prescription from a health care practitioner shall not be required for
17	17	8coverage of opioid antagonists. An opioid antagonist used in the reversal of overdoses caused by
18	18	9opioids shall not be subject to any deductible, coinsurance, copayments or out-of-pocket limits;
19	19	10provided, however, that cost-sharing shall be required if the applicable plan is governed by the
20	20	11Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on cost-
21	21	12sharing for this service.
22	22	13 (b) The commission shall provide coverage for an opioid antagonist used in the reversal
23	23	14of overdoses caused by opioids as a medical benefit when dispensed by the health care facility in
24	24	15which the opioid antagonist was prescribed and shall provide coverage as a pharmacy benefit for
25	25	16an opioid antagonist used in the reversal of overdoses caused by opioids dispensed by a 2 of 31
26	26	17pharmacist, including an opioid antagonist dispensed pursuant to section 19B of chapter 94C;
27	27	18provided, however, that the rate to be reimbursed under the medical benefit shall not exceed the
28	28	19commission’s average in-network pharmacy benefit rate and the health care facility shall not
29	29	20balance bill the patient.
30	30	21 Section 17U. The commission shall provide to any active or retired employee of the
31	31	22commonwealth who is insured under the group insurance commission coverage for the provision
32	32	23of services by a recovery coach licensed or otherwise authorized to practice pursuant to chapter
33	33	24111J, irrespective of the setting in which the services are provided; provided, however, that such
34	34	25services shall be within the lawful scope of practice of a recovery coach. The contractual rate for
35	35	26these services shall be not less than the prevailing MassHealth rate for recovery coach services.
36	36	27The benefits in this section shall not be subject to any deductible, coinsurance, copayments or
37	37	28out-of-pocket limits; provided, however, that cost-sharing shall be required if the applicable plan
38	38	29is governed by the Internal Revenue Code and would lose its tax-exempt status as a result of the
39	39	30prohibition on cost-sharing for the service. Recovery coach services shall not require prior
40	40	31authorization.
41	41	32 SECTION 2. Chapter 94C of the General Laws is hereby amended by striking out section
42	42	3319C, as appearing in the 2022 Official Edition, and inserting in place thereof the following
43	43	34section:-
44	44	35 Section 19C. The board of registration in pharmacy shall promulgate regulations
45	45	36requiring pharmacies located in areas with high incidents of opiate overdose, as determined by
46	46	37the board in consultation with the department, to maintain a continuous supply of opioid
47	47	38antagonists, as defined in section 19B; provided, however, that the continuous supply of opioid 3 of 31
48	48	39antagonists shall include opioid antagonists that are approved by the United States Food and
49	49	40Drug Administration to be sold over the counter without a prescription; provided further, that
50	50	41such pharmacies shall notify the department if the supply or stock of opioid antagonist doses is
51	51	42insufficient to enable compliance with maintaining a continuous supply of opioid antagonists.
52	52	43 SECTION 3. Said chapter 94C is hereby further amended by inserting after section 19D
53	53	44the following section:-
54	54	45 Section 19D½. (a) For the purposes of this section, the following words shall have the
55	55	46following meanings unless the context clearly requires otherwise:
56	56	47 “Opioid antagonist”, as defined in section 19B.
57	57	48 “Substance use disorder treatment facility”, a facility licensed or approved by the
58	58	49department to offer treatment for substance use disorder, including, but not limited to: (i)
59	59	50withdrawal management services; (ii) clinical stabilization services; (iii) transitional support
60	60	51services; (iv) residential support services; (v) community behavioral health center services; (vi)
61	61	52office-based opioid or addiction treatment services; or (vii) outpatient substance use disorder
62	62	53services.
63	63	54 (b) Upon discharge of a patient with an opioid use disorder from a substance use disorder
64	64	55treatment facility, the facility shall educate the patient on the use of opioid antagonists and
65	65	56dispense not less than 2 doses of an opioid antagonist to the patient or a legal guardian of the
66	66	57patient.
67	67	58 (c) The commissioner may promulgate rules and regulations necessary to implement this
68	68	59section. 4 of 31
69	69	60 SECTION 4. Section 25J½ of chapter 111 of the General Laws, as appearing in the 2022
70	70	61Official Edition, is hereby amended by inserting after the first paragraph the following
71	71	62paragraph:-
72	72	63 Upon discharge of a patient from an acute care hospital, satellite emergency facility or a
73	73	64freestanding psychiatric hospital who has: (i) a history of or is actively using opioids; (ii) been
74	74	65diagnosed with opioid use disorder; or (iii) experienced an opioid-related overdose, the acute
75	75	66care hospital or satellite emergency facility shall educate the patient on the use of opioid
76	76	67antagonists, as defined in section 19B of chapter 94C, and prescribe or dispense not less than 2
77	77	68doses of an opioid antagonist to the patient or a legal guardian of the patient.
78	78	69 SECTION 5. Said chapter 111 is hereby further amended by inserting after section 215
79	79	70the following section:-
80	80	71 Section 215A. (a) For the purposes of the section, the following words shall have the
81	81	72following meanings unless the context clearly requires otherwise:
82	82	73 “Drug testing services”, the use of testing equipment for the surveillance or identification
83	83	74of, or to analyze the strength, effectiveness or purity of, a controlled substance related to its
84	84	75injection, inhalation or ingestion by a person to determine whether the controlled substance
85	85	76contains chemicals, toxic substances or hazardous compounds.”
86	86	77 “Harm reduction program”, a department approved program or service that reduces the
87	87	78adverse consequences of substance use, including use-related mortality, stabilizes and improves
88	88	79the health of people who use substances and advances public health; provided, however, that
89	89	80programs or services may include harm reduction services, including, but not be limited to: (i)
90	90	81needle exchange programs pursuant to section 215; (ii) primary care, including disease 5 of 31
91	91	82prevention and health screenings; (iii) access or referral to evidence-based treatment options; (iv)
92	92	83drug testing services; (v) overdose reversal care; (vi) supervision of persons who consume pre-
93	93	84obtained substances; and (vii) other social support services deemed permissible by the
94	94	85department.
95	95	86 “Harm reduction program operators”, individuals directly involved in the operation,
96	96	87administration or staffing of a harm reduction program, including directors, board members,
97	97	88consultants, health care providers, service providers, staff and volunteers.
98	98	89 (b) Prior to the establishment of a harm reduction program that provides overdose
99	99	90reversal care and supervision of persons who consume pre-obtained substances, the board of
100	100	91health of the city or town in which the program is located shall vote to approve or deny such
101	101	92program. If the board approves such program the municipal legislative body shall vote to
102	102	93approve or deny such program in the manner provided for in section 4 of chapter 4not later than
103	103	943 months following the approval by the board of health. If such program is approved by each
104	104	95body, the city or town shall provide notice of such approval to the department, in a manner
105	105	96determined by the department, and upon such notice, the department shall review the proposed
106	106	97program and make a determination of whether to authorize such program; provided, however,
107	107	98that in making the determination, the department shall take into consideration the program’s
108	108	99proposed location, including, but not limited to, the location’s proximity to schools; provided,
109	109	100further that the department shall provide the determination in writing not later than 3 months
110	110	101after receiving notice of approval from the city or town and, if applicable, shall provide an
111	111	102explanation for rejecting a proposed program; and provided further, that the department shall
112	112	103submit any such program to the attorney general to ensure compliance with state and federal law. 6 of 31
113	113	104 Not later than 1 year after the implementation of a harm reduction program under this
114	114	105subsection, the department shall report the results of authorized programs pursuant to this section
115	115	106and any recommendations by filing the report with the clerks of the senate and house of
116	116	107representatives, the joint committee on mental health, substance use and recovery, the joint
117	117	108committee on public health and the senate and house committees on ways and means; provided,
118	118	109however, that the report shall include, but not be limited to, site-specific information on the: (i)
119	119	110number of participant visits; (ii) types of drugs consumed and tested; (iii) number of overdoses
120	120	111reversed; (iv) types of drugs involved in overdoses; (v) staffing levels and staff experiences; (vi)
121	121	112operating costs; (vii) number of referrals to addiction treatment; (viii) number of hypodermic
122	122	113needles and syringes collected and distributed; (ix) medical emergency and 911 calls; and (x) in
123	123	114consultation with local law enforcement, report on changes to the prevalence of crimes in the
124	124	115vicinity of the program.
125	125	116 (c) Notwithstanding any general or special law to the contrary, harm reduction program
126	126	117operators, individuals who access harm reduction program services, owners, lessors and sub-
127	127	118lessors of property used for harm reduction programs and state, county and municipal employees
128	128	119involved in approving or operating harm reduction programs shall, for actions related to the
129	129	120approval or operation of, or participation in, a harm reduction program, be immune from: (i)
130	130	121arrest, charge or prosecution, including for attempting, aiding and abetting or conspiracy to
131	131	122commit a violation, pursuant to sections 32, 32A, 32B, 32C, 32D, 32E, 32I, 34, 40, 43 and 47 of
132	132	123chapter 94C and chapter 271A; (ii) seizure or forfeiture of data, records, assets or property under
133	133	124state law; (iii) civil suit, liability or damages alleged to have been sustained by an act or omission
134	134	125by a harm reduction program operator in the course of providing harm reduction services; and
135	135	126(iv) for health care providers, disciplinary action by a professional licensing board, credentialing 7 of 31
136	136	127restriction, contractual liability, adverse employment action or denial of any professional
137	137	128privilege; provided, however, that the immunity described in this subsection shall apply only if
138	138	129the harm reduction program operates in good faith in accordance with this section and regulatory
139	139	130requirements issued by the department. Entering or exiting a harm reduction program cannot
140	140	131serve as the basis for, or a fact contributing to the existence of, reasonable suspicion or probable
141	141	132cause to conduct a search or seizure.
142	142	133 (d) The immunity provided under subsection (c) shall not apply: (i) if the damage was
143	143	134caused by an act or omission constituting gross negligence or recklessness, conduct with an
144	144	135intent to harm, discrimination based on race, ethnicity, national origin, religion, disability, sexual
145	145	136orientation or gender identity or conduct outside the scope of responsibility of a harm reduction
146	146	137program employee or volunteer, as determined by the department; (ii) to consumer protection
147	147	138actions brought by the attorney general; (iii) to false claims actions brought by or on behalf of
148	148	139the commonwealth; or (iv) privacy violations.
149	149	140 (e) Notwithstanding any general law or special law to the contrary, a person or entity
150	150	141providing harm reduction services under this section and approved by the department shall not be
151	151	142required to register their activities pursuant to section 7 of chapter 94C.
152	152	143 (f) The department shall promulgate regulations to implement this section.
153	153	144 SECTION 6. Said chapter 111 is hereby further amended by adding the following
154	154	145section:-
155	155	146 Section 245. (a) As used in this section, the following words shall have the following
156	156	147meanings unless the context clearly requires otherwise: 8 of 31
157	157	148 “Acupuncture detoxification specialist”, a qualified health care professional who is
158	158	149registered with the department to engage in the practice of auricular acupuncture detoxification
159	159	150pursuant to this section.
160	160	151 “Auricular acupuncture detoxification”, treatment by means of the subcutaneous insertion
161	161	152of sterile, disposable acupuncture needles in consistent, predetermined bilateral locations on the
162	162	153ear in accordance with the standardized auricular acupuncture detoxification protocol developed
163	163	154by National Acupuncture Detoxification Association, Inc.
164	164	155 “General supervision”, supervision by phone or other electronic means during business
165	165	156hours with in-person site visits as deemed necessary by a licensed acupuncturist.
166	166	157 “Licensed acupuncturist”, an individual who is licensed under sections 148 to 162,
167	167	158inclusive, of chapter 112 to practice as a licensed acupuncturist.
168	168	159 “National Acupuncture Detoxification Association training”, the standardized auricular
169	169	160acupuncture detoxification protocol training developed by National Acupuncture Detoxification
170	170	161Association, Inc., effective as of January 1, 2019.
171	171	162 “Qualified health care professional”, a qualified individual who: (i) is a licensed
172	172	163physician, licensed psychologist, licensed independent clinical social worker, licensed clinical
173	173	164social worker, licensed mental health counselor, licensed psychiatric clinical nurse specialist,
174	174	165certified addictions registered nurse, licensed alcohol and drug counselor I or licensed alcohol
175	175	166and drug counselor II as defined in section 1 of chapter 111J, certified alcohol and drug abuse
176	176	167counselor or certified alcohol and drug abuse counselor II as certified by the Massachusetts
177	177	168Board of Substance Abuse Counselor Certification or an equivalent certifying body or a
178	178	169registered nurse or nurse practitioner certified by the board of registration in nursing pursuant to 9 of 31
179	179	170chapter 112; and (ii) has received training and a certificate of completion from National
180	180	171Acupuncture Detoxification Association, Inc. or from a state-recognized organization or agency
181	181	172that meets or exceeds National Acupuncture Detoxification Association, Inc. training standards
182	182	173to engage in the practice of auricular acupuncture detoxification protocol for the treatment of
183	183	174addictions, mental and behavioral health, trauma as a result of a disaster and other emotional
184	184	175trauma.
185	185	176 (b) An individual who is not a licensed acupuncturist shall not engage in the practice of
186	186	177the auricular acupuncture detoxification or represent themself as an acupuncture detoxification
187	187	178specialist unless the individual: (i) has been issued: (A) an approved registration by the
188	188	179department to practice auricular acupuncture detoxification in accordance with this section; or
189	189	180(B) a license or certificate in another state with requirements that are at least equivalent to the
190	190	181requirements of this section, as determined by the commissioner; and (ii) has been trained in the
191	191	182standardized auricular acupuncture detoxification protocol in accordance with National
192	192	183Acupuncture Detoxification Association, Inc. training or an equivalent training certificate by a
193	193	184state-recognized organization.
194	194	185 To engage in the practice of auricular acupuncture detoxification within the individual’s
195	195	186designated lawful scope of practice, a qualified health care professional shall file an application
196	196	187to register as an acupuncture detoxification specialist with the department, in a form determined
197	197	188by the department. Each application may be accompanied by the payment of a fee to be
198	198	189determined by the department.
199	199	190 The applicant seeking to practice auricular acupuncture detoxification shall, at a
200	200	191minimum, furnish proof of: (i) relevant licensure or certification as a qualified health care 10 of 31
201	201	192professional; and (ii) completion of National Acupuncture Detoxification Association, Inc.
202	202	193training or an equivalent training certificate by a state-recognized organization. An applicant
203	203	194who is registered or certified in another state with requirements that are at least equivalent to the
204	204	195requirements of this section, as determined by the commissioner, shall be allowed to practice
205	205	196auricular acupuncture detoxification in accordance with this section. A registration issued under
206	206	197this section shall be valid for 2 years and subject to renewal as determined by the department.
207	207	198 (c) Auricular acupuncture detoxification shall only be performed by a licensed
208	208	199acupuncturist or a qualified health care professional within their designated lawful scope of
209	209	200practice for the purpose of providing integrated health care delivery interventions in substance
210	210	201abuse treatment and wellness promotion including, but not limited to, treating mental and
211	211	202emotional health, post and acute trauma, addiction or chemical dependency.
212	212	203 (d) A qualified health care professional registered in accordance with this section shall
213	213	204only practice under the general supervision of a licensed acupuncturist; provided, however, that
214	214	205no such individual shall use the title “acupuncturist” or otherwise represent themself or imply
215	215	206that they are a licensed acupuncturist and shall not perform or practice acupuncture outside of the
216	216	207scope of the auricular acupuncture detoxification as defined in this section.
217	217	208 (e) Nothing in this chapter or sections 149 to 162, inclusive, of chapter 112 shall prohibit,
218	218	209limit, interfere with or prevent a qualified health care professional from practicing or performing
219	219	210auricular acupuncture detoxification if the individual is acting within the lawful scope of practice
220	220	211in accordance with the individual’s license and the auricular acupuncture detoxification is
221	221	212performed in: (i) a private, freestanding facility licensed by the department that provides care or
222	222	213treatment for individuals with substance use disorders or other addictive disorders; (ii) a facility 11 of 31
223	223	214under the direction and supervision of the department of mental health; (iii) a setting approved or
224	224	215licensed by the department of mental health; or (iv) any other setting where auricular
225	225	216acupuncture detoxification is an appropriate adjunct therapy to a substance use disorder or
226	226	217behavioral health treatment program; provided, however, that individual or 1-on-1 appointments
227	227	218with a health care provider not within a setting pursuant to this subsection shall not be an
228	228	219appropriate setting in accordance with this section.
229	229	220 (f) The commissioner may promulgate regulations to implement this section.
230	230	221 SECTION 7. Chapter 111J of the General Laws is hereby amended by striking out
231	231	222sections 1 to 8, inclusive, as appearing in the 2022 Official Edition, and inserting in place thereof
232	232	223the following 9 sections:-
233	233	224 Section 1. As used in this chapter, the following words shall have the following meanings
234	234	225unless the context clearly requires otherwise:
235	235	226 “Applicant”, an individual seeking licensure under this chapter.
236	236	227 “Approved continuing education”, continuing education approved by the department,
237	237	228including research and training programs, college and university courses, in-service training
238	238	229programs, seminars and conferences, designed to maintain and enhance the skills of licensees.
239	239	230 “Approved program”, a program approved by the department for the education and
240	240	231training of licensees.
241	241	232 “Approved recovery coach supervisor”, a licensed recovery coach that has completed
242	242	233recovery coach supervision training that has been approved by the department for the supervision
243	243	234of recovery coaches. 12 of 31
244	244	235 “Approved work experience”, supervised work experience, approved by the department,
245	245	236in the practice area for which an applicant seeks licensure.
246	246	237 “Department”, the department of public health.
247	247	238 “Licensee”, an individual who is licensed under this chapter.
248	248	239 “Licensed alcohol and drug counselor I”, a person licensed by the department to conduct
249	249	240an independent practice of alcohol and drug counseling and provide supervision to other alcohol
250	250	241and drug counselors; provided, however, that a “licensed alcohol and drug counselor I” shall
251	251	242have: (i) received a master’s or doctoral degree in behavioral sciences, which included a
252	252	243supervised counseling practicum that meets the requirements established by the department, or
253	253	244such equivalent educational credits as may be established by the department; (ii) not less than 3
254	254	245years of approved work experience; and (iii) passed a licensing examination approved by the
255	255	246department.
256	256	247 “Licensed alcohol and drug counselor II”, a person licensed by the department to practice
257	257	248alcohol and drug counseling under clinical supervision; provided, however, that a “licensed
258	258	249alcohol and drug counselor II” shall have: (i) completed an approved program of education,
259	259	250which included a supervised counseling practicum that meets the requirements established by the
260	260	251department or such equivalent educational credits as may be established by the department; (ii)
261	261	252not less than 3 years of approved work experience; and (iii) passed a licensing examination
262	262	253approved by the department.
263	263	254 “Licensed recovery coach”, a person with lived experience who is licensed by the
264	264	255department to practice recovery coaching using shared understanding, respect and mutual
265	265	256empowerment to help others become and stay engaged in the process of recovery from a 13 of 31
266	266	257substance use disorder; provided, however, that a “licensed recovery coach” shall: (i) have
267	267	258completed an approved program of education, including approved work experience that meets
268	268	259the requirements established by the department; (ii) demonstrate not less than 2 years of
269	269	260sustained recovery; and (iii) have met all education, training and experience requirements and
270	270	261qualifications as established by the department.
271	271	262 “Lived experience”, the experience of addiction and recovery from a substance use
272	272	263disorder.
273	273	264 Section 2. (a) The department shall establish and administer a program for the licensure
274	274	265of alcohol and drug counselors I, alcohol and drug counselors II and recovery coaches. The
275	275	266department shall: (i) establish the licensure requirements for licensed alcohol and drug
276	276	267counselors practicing in the commonwealth; (ii) establish the licensure requirements for licensed
277	277	268recovery coaches practicing in the commonwealth; (iii) evaluate the qualifications of applicants
278	278	269for licensure; (iv) supervise licensing examinations, where applicable; (v) establish and collect
279	279	270fees for licensing and examination, where applicable; (vi) grant and issue licenses to applicants
280	280	271who satisfy the department’s requirements for licensure; (vii) establish continuing education
281	281	272requirements for licensees; (viii) investigate complaints; (ix) take appropriate disciplinary action
282	282	273to protect the public health, safety and welfare; and (x) perform other functions and duties as
283	283	274may be necessary to carry out this chapter.
284	284	275 (b) The department shall establish requirements for licensed alcohol and drug counselors
285	285	276I and licensed alcohol and drug counselors II and may establish other reasonable classifications
286	286	277for alcohol and drug counselors as it finds necessary and appropriate, including, but not limited 14 of 31
287	287	278to, counselors specializing in youth recovery counseling, taking into consideration different
288	288	279levels of education, training and work experience.
289	289	280 (c) The department shall establish requirements for licensed recovery coaches, including,
290	290	281but not limited to, establishing an ethical code of conduct for recovery coaches, and may
291	291	282establish other reasonable classifications for recovery coaches as it finds necessary and
292	292	283appropriate, taking into consideration different levels of education, training and work experience.
293	293	284 (d) The department shall approve and issue certificates of approval of programs for the
294	294	285training of alcohol and drug counselors. The department shall maintain a list of approved
295	295	286programs and a current roster of persons serving as licensed alcohol and drug counselors in the
296	296	287commonwealth.
297	297	288 (e) The department shall approve and issue certificates of approval of programs for the
298	298	289training of recovery coaches. The department shall maintain a list of approved programs and a
299	299	290current roster of persons serving as licensed recovery coaches in the commonwealth.
300	300	291 (f) The department shall promulgate rules and regulations to implement this chapter,
301	301	292including, but not limited to, rules and regulations establishing the educational and professional
302	302	293requirements for licensing individuals under this chapter, establishing fees for licensing and
303	303	294examination, where applicable, and governing the practice and employment of licensees to
304	304	295promote the public health, safety and welfare.
305	305	296 Section 3. (a) Each applicant shall furnish the department with proof of satisfactory
306	306	297completion of the educational, training and experience requirements for licensure, including
307	307	298completion of an approved program and approved work experience and proof of having passed 15 of 31
308	308	299any licensing examinations required by the department; provided, however, that the department
309	309	300may establish additional requirements for licensure and exemptions by regulation.
310	310	301 (b) A license for alcohol and drug counselor I, alcohol and drug counselor II or recovery
311	311	302coaches shall be valid for a 2-year period and licensees may apply for renewal of a license for a
312	312	303like term. A licensee seeking renewal of a license shall submit proof of having successfully
313	313	304completed the requirements for approved continuing education as may be established by the
314	314	305department.
315	315	306 (c) Applications for licenses and renewals shall be submitted in accordance with
316	316	307procedures established by the department. The department may establish fees for license
317	317	308applications and renewals.
318	318	309 Section 4. (a) Except as otherwise provided in this chapter or by regulation, a person not
319	319	310licensed or otherwise exempt from licensing shall not hold themself out as a licensed recovery
320	320	311coach and shall not use the title, initials, abbreviations, insignia or description of a licensed
321	321	312recovery coach or practice or attempt to practice recovery coaching unless otherwise authorized
322	322	313by law or rule or regulation of the department. Whoever engages in any such unauthorized action
323	323	314shall be subject to a fine of not less than $500. The department may bring a petition in superior
324	324	315court to enjoin such unauthorized action or any other violation of this chapter or regulation
325	325	316hereunder.
326	326	317 (b) Individuals working under an approved recovery coach supervisor and receiving
327	327	318approved work experience may practice without a license in order to obtain the requisite hours of
328	328	319supervised experience needed to obtain a recovery coach license. 16 of 31
329	329	320 (c) Nothing in this section shall prevent members of peer groups or self-help groups from
330	330	321performing peer support or self-help activities that may be included within the practice recovery
331	331	322coaching; provided, however, that no members of peer groups or self-help groups who are not so
332	332	323credentialed shall use a title stating or implying that such person is a licensed recovery coach.
333	333	324 Section 5. (a) Except as otherwise provided in this chapter or by regulation, a person who
334	334	325is not licensed or is otherwise exempt from licensing shall not hold themself out as a licensed
335	335	326alcohol and drug counselor and shall not use the title, initials or description of a licensed alcohol
336	336	327and drug counselor or practice or attempt to practice alcohol and drug counseling. Whoever
337	337	328engages in any such unauthorized action shall be subject to a fine of not less than $500. The
338	338	329department may bring a petition in superior court to enjoin such unauthorized action or any other
339	339	330violation of this chapter or regulation hereunder.
340	340	331 (b) The following individuals shall be exempt from the licensing requirements for alcohol
341	341	332and drug counseling under this chapter:
342	342	333 (i) an educational psychologist, marriage and family therapist, mental health counselor,
343	343	334nurse practitioner, occupational therapist, physician, physician assistant, practical nurse,
344	344	335psychologist, registered nurse, rehabilitation counselor or social worker;
345	345	336 (ii) an employee or other agent of a recognized academic institution or employee
346	346	337assistance program, a federal, state, county or local government institution, program, agency or
347	347	338facility or school committee, school district, school board or board of regents while performing
348	348	339alcohol and drug counseling duties solely for the respective entity or under the jurisdiction of
349	349	340such entity; provided, however, that a license pursuant to this chapter shall not be a requirement
350	350	341for employment in any state, county or municipal agency; and 17 of 31
351	351	342 (iii) an employee of a treatment program or facility licensed or approved by the
352	352	343department pursuant to chapters 111B and 111E; provided, however, that such individual shall
353	353	344perform alcohol and drug counseling solely within or under the jurisdiction of such program or
354	354	345facility.
355	355	346 (c) Nothing in this section shall prevent qualified members of other professions,
356	356	347including attorneys, Christian Science practitioners or members of the clergy, from providing
357	357	348alcohol or drug counseling consistent with accepted standards of their respective professions;
358	358	349provided, however, that no such person shall use a title stating or implying that such person is a
359	359	350licensed alcohol and drug counselor.
360	360	351 (d) Nothing in this section shall prevent members of peer groups or self-help groups from
361	361	352performing peer group or self-help activities; provided, however, that no such person shall use a
362	362	353title stating or implying that such person is a licensed alcohol and drug counselor.
363	363	354 Section 6. (a) The department shall establish procedures for consumers to file written
364	364	355complaints regarding an individual licensed under this chapter. The department shall investigate
365	365	356all complaints relating to the practice of a person holding a license under this chapter and all
366	366	357complaints relating to any violation of this chapter or regulation promulgated hereunder.
367	367	358 (b) The department may conduct an adjudicatory proceeding pursuant to chapter 30A but
368	368	359shall not issue, vacate, modify or enforce subpoenas pursuant to section 12 of said chapter 30A.
369	369	360The department may, after a hearing pursuant to said chapter 30A, deny, refuse renewal, revoke,
370	370	361limit or suspend a license or otherwise discipline a licensee; provided, however, that the
371	371	362department may suspend the license of a licensee who poses an imminent danger to the public
372	372	363without a hearing; provided further, that the licensee shall be afforded a hearing within 7 18 of 31
373	373	364business days of receipt of a notice of such denial, refusal to renew, revocation, limitation,
374	374	365suspension or other disciplinary action; and provided further, that the department shall conduct
375	375	366its proceedings in accordance with this chapter and said chapter 30A. Grounds for denial, refusal
376	376	367to renew, revocation, limitation, suspension or other disciplinary action shall include: (i) fraud or
377	377	368misrepresentation in obtaining a license; (ii) criminal conduct which the department determines
378	378	369to be of such a nature as to render such person unfit to practice as evidenced by criminal
379	379	370proceedings resulting in a conviction, guilty plea or plea of nolo contendere or an admission of
380	380	371sufficient facts; (iii) a violation of any law or rule or regulation of the department governing the
381	381	372practice of the licensee under this chapter; (iv) a violation of ethical standards which the
382	382	373department determines to be of such a nature as to render such person unfit to practice as a
383	383	374licensee; or (v) other just and sufficient cause that the department determines would render a
384	384	375person unfit to practice as a licensee.
385	385	376 (c) Where denial, refusal to renew, revocation or suspension is based solely on the failure
386	386	377of the licensee to timely file an application or pay prescribed fees or to maintain insurance
387	387	378coverage as required by applicable law or regulation, the department may act without first
388	388	379granting the applicant or licensee a hearing.
389	389	380 Section 7. Examinations for licensure, where applicable, shall be conducted not less than
390	390	381twice per year at times and places and in formats designated by the department. Examinations for
391	391	382licensure, where applicable, shall be written; provided, however, that portions thereof may be
392	392	383conducted orally at the department’s discretion; and provided further, that a person who fails an
393	393	384examination may be admitted to the next available examination. 19 of 31
394	394	385 Section 8. (a) The department may issue a license without examination to an applicant
395	395	386who meets the requirements for licensure; provided, however, that requirements for licensure in
396	396	387another state shall be determined by the department to be equivalent to or in excess of the
397	397	388requirements of this chapter; and provided further, that such applicant is: (i) licensed or certified
398	398	389in alcohol and drug counseling or a comparable field in another state; or (ii) licensed or certified
399	399	390in recovery coaching or a comparable field in another state.
400	400	391 (b) The department shall promulgate rules and regulations as may be necessary to
401	401	392implement this section.
402	402	393 Section 9. The bureau of substance addiction services shall establish a comprehensive
403	403	394peer support program to provide mentorship, technical assistance and resources to support the
404	404	395skill-building and credentialing of peers working in substance addition recovery services,
405	405	396including, but not limited to, peer workers and recovery coaches. The program shall include, but
406	406	397not be limited to: (i) a network for peer-to-peer trainings, education, mentorship, counseling and
407	407	398support; (ii) educational and other support materials; (iii) technical assistance for licensure,
408	408	399certification, credentialing and other employment and practice requirements; and (iv) billing
409	409	400technical assistance for organizations that employ recovery coaches. The bureau shall consult
410	410	401peers working in substance addition recovery services in the establishment of such
411	411	402comprehensive peer support program.
412	412	403 SECTION 8. Chapter 112 of the General Laws is hereby amended by inserting after
413	413	404section 155 the following section:-
414	414	405 Section 155A. Nothing in this chapter shall prohibit, limit, interfere with or prevent a
415	415	406licensed physician or acupuncturist from practicing or performing auricular acupuncture 20 of 31
416	416	407detoxification, as defined in section 245 of chapter 111, if the licensed physician or acupuncturist
417	417	408is acting within the lawful scope of practice in accordance with their license.
418	418	409 SECTION 9. Chapter 118E of the General Laws is hereby amended by inserting after
419	419	410section 10Q the following 2 sections:-
420	420	411 Section 10R. (a) The division and its contracted health insurers, health plans, health
421	421	412maintenance organizations, behavioral health management firms and third-party administrators
422	422	413under contract to a Medicaid managed care organization, accountable care organization or
423	423	414primary care clinician plan shall provide coverage for prescribed or dispensed opioid antagonists,
424	424	415as defined in section 19B of chapter 94C and used in the reversal of overdoses caused by opioids,
425	425	416which shall not require prior authorization; provided, however, that a prescription from a health
426	426	417care practitioner shall not be required for coverage of opioid antagonists. An opioid antagonist
427	427	418used in the reversal of overdoses caused by opioids shall not be subject to any deductible,
428	428	419coinsurance, copayments or out-of-pocket limits; provided, however, that cost-sharing shall be
429	429	420required if the applicable plan is governed by the Internal Revenue Code and would lose its tax-
430	430	421exempt status as a result of the prohibition on cost-sharing for this service.
431	431	422 (b) The division and its contracted health insurers, health plans, health maintenance
432	432	423organizations, behavioral health management firms and third-party administrators under contract
433	433	424to a Medicaid managed care organization, accountable care organization or primary care
434	434	425clinician plan shall provide coverage for an opioid antagonist used in the reversal of overdoses
435	435	426caused by opioids as a medical benefit when dispensed by the health care facility in which the
436	436	427opioid antagonist was prescribed and shall provide coverage as a pharmacy benefit for an opioid
437	437	428antagonist used in the reversal of overdoses caused by opioids dispensed by a pharmacist, 21 of 31
438	438	429including an opioid antagonist dispensed pursuant to section 19B of chapter 94C; provided,
439	439	430however, that the rate to be reimbursed under the medical benefit shall not exceed the carrier’s
440	440	431average in-network pharmacy benefit rate and the health care facility shall not balance bill the
441	441	432patient.
442	442	433 Section 10S. The division and its contracted health insurers, health plans, health
443	443	434maintenance organizations, behavioral health management firms and third-party administrators
444	444	435under contract to a Medicaid managed care organization, accountable care organization or
445	445	436primary care clinician plan shall provide coverage for the provision of services by a recovery
446	446	437coach licensed or otherwise authorized to practice pursuant to chapter 111J, irrespective of the
447	447	438setting in which these services are provided; provided, however, that such services shall be
448	448	439within the lawful scope of practice of a recovery coach. The benefits in this section shall not be
449	449	440subject to any deductible, coinsurance, copayments or out-of-pocket limits; and provided further,
450	450	441that recovery coach services shall not require prior authorization.
451	451	442 SECTION 10. Chapter 175 of the General Laws is hereby amended by inserting after
452	452	443section 47UU the following 2 sections:-
453	453	444 Section 47VV. (a) Any policy, contract, agreement, plan or certificate of insurance
454	454	445issued, delivered or renewed within the commonwealth, which is considered creditable coverage
455	455	446under section 1 of chapter 111M, shall provide coverage for prescribed or dispensed opioid
456	456	447antagonists, as defined in section 19B of chapter 94C and used in the reversal of overdoses
457	457	448caused by opioids, which shall not require prior authorization; provided, however, that a
458	458	449prescription from a health care practitioner shall not be required for coverage of opioid
459	459	450antagonists. An opioid antagonist used in the reversal of overdoses caused by opioids shall not be 22 of 31
460	460	451subject to any deductible, coinsurance, copayments or out-of-pocket limits; provided, however,
461	461	452that cost-sharing shall be required if the applicable plan is governed by the Internal Revenue
462	462	453Code and would lose its tax-exempt status as a result of the prohibition on cost-sharing for this
463	463	454service.
464	464	455 (b) The policy, contract, agreement, plan or certificate of insurance shall provide
465	465	456coverage for an opioid antagonist used in the reversal of overdoses caused by opioids as a
466	466	457medical benefit when dispensed by the health care facility in which the opioid antagonist was
467	467	458prescribed and shall provide coverage as a pharmacy benefit for an opioid antagonist used in the
468	468	459reversal of overdoses caused by opioids dispensed by a pharmacist, including an opioid
469	469	460antagonist dispensed pursuant to section 19B of chapter 94C; provided, however, that the rate to
470	470	461be reimbursed under the medical benefit shall not exceed the carrier’s average in-network
471	471	462pharmacy benefit rate and the health care facility shall not balance bill the patient.
472	472	463 Section 47WW. Any policy, contract, agreement, plan or certificate of insurance issued,
473	473	464delivered or renewed within the commonwealth, which is considered creditable coverage under
474	474	465section 1 of chapter 111M, shall provide coverage for the provision of services by a recovery
475	475	466coach licensed or otherwise authorized to practice under chapter 111J, irrespective of the setting
476	476	467in which these services are provided; provided, however, that such services shall be within the
477	477	468lawful scope of practice of a recovery coach. The contractual rate for these services shall be not
478	478	469less than the prevailing MassHealth rate for recovery coach services. The benefits in this section
479	479	470shall not be subject to any deductible, coinsurance, copayments or out-of-pocket limits;
480	480	471provided, however, that cost-sharing shall be required if the applicable plan is governed by the
481	481	472Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on cost- 23 of 31
482	482	473sharing for this service; and provided further, that recovery coach services shall not require prior
483	483	474authorization.
484	484	475 SECTION 11. Said chapter 175 is hereby further amended by inserting after section
485	485	476122A the following section:-
486	486	477 Section 122B. (a) No insurer authorized to issue policies on the lives of persons in the
487	487	478commonwealth shall make a distinction or otherwise discriminate between persons, reject an
488	488	479applicant, cancel a policy or demand or require a higher rate of premium for reasons based solely
489	489	480upon the fact that an applicant or insured has or had a prescription for, purchased or otherwise
490	490	481possessed an opioid antagonist, as defined in section 19B of chapter 94C.
491	491	482 (b) A violation of this section shall constitute an unfair method of competition or unfair
492	492	483and deceptive act or practice pursuant to chapters 93A and 176D.
493	493	484 SECTION 12. Section 193U of said chapter 175, as appearing in the 2022 Official
494	494	485Edition, is hereby amended by striking out, in lines 21 to 26, inclusive, the words “or (iii)
495	495	486abusive litigation against a provider concerning reproductive health care services or gender-
496	496	487affirming health care services resulted in a judgment against the provider, if such health care
497	497	488services would be lawful and consistent with good medical practice as provided if they occurred
498	498	489entirely in the commonwealth” and inserting in place thereof the following words:- (iii) abusive
499	499	490litigation against a provider concerning reproductive health care services or gender-affirming
500	500	491health care services resulted in a judgment against the provider, if such health care services
501	501	492would be lawful and consistent with good medical practice as provided if they occurred entirely
502	502	493in the commonwealth; or (iv) the health care provider provides services at a harm reduction
503	503	494program. 24 of 31
504	504	495 SECTION 13. Chapter 176A of the General Laws is hereby amended by inserting after
505	505	496section 8VV the following 2 sections:-
506	506	497 Section 8WW. (a) Any contract between a subscriber and the corporation under an
507	507	498individual or group hospital service plan that is delivered, issued or renewed within the
508	508	499commonwealth shall provide coverage for prescribed or dispensed opioid antagonists, as defined
509	509	500in section 19B of chapter 94C and used in the reversal of overdoses caused by opioids, which
510	510	501shall not require prior authorization; provided, however, that a prescription from a health care
511	511	502practitioner shall not be required for coverage of opioid antagonists. An opioid antagonist used in
512	512	503the reversal of overdoses caused by opioids shall not be subject to any deductible, coinsurance,
513	513	504copayments or out-of-pocket limits; provided, however, that cost-sharing shall be required if the
514	514	505applicable plan is governed by the Internal Revenue Code and would lose its tax-exempt status
515	515	506as a result of the prohibition on cost-sharing for this service.
516	516	507 (b) Such contracts shall provide coverage for an opioid antagonist used in the reversal of
517	517	508overdoses caused by opioids as a medical benefit when dispensed by the health care facility in
518	518	509which the opioid antagonist was prescribed and shall provide coverage as a pharmacy benefit for
519	519	510an opioid antagonist used in the reversal of overdoses caused by opioids dispensed by a
520	520	511pharmacist, including an opioid antagonist dispensed pursuant to section 19B of chapter 94C;
521	521	512provided, however, that the rate to be reimbursed under the medical benefit shall not exceed the
522	522	513carrier’s average in-network pharmacy benefit rate and the health care facility shall not balance
523	523	514bill the patient.
524	524	515 Section 8XX. Any contract between a subscriber and the corporation under an individual
525	525	516or group hospital service plan that is delivered, issued or renewed within the commonwealth 25 of 31
526	526	517shall provide coverage for the provision of services by a recovery coach licensed or otherwise
527	527	518authorized to practice under chapter 111J, irrespective of the setting in which these services are
528	528	519provided; provided, however, that such services shall be within the lawful scope of practice of a
529	529	520recovery coach. The contractual rate for these services shall be not less than the prevailing
530	530	521MassHealth rate for recovery coach services. The benefits in this section shall not be subject to
531	531	522any deductible, coinsurance, copayments or out-of-pocket limits; provided, however, that cost-
532	532	523sharing shall be required if the applicable plan is governed by the Internal Revenue Code and
533	533	524would lose its tax-exempt status as a result of the prohibition on cost-sharing for this service.
534	534	525Recovery coach services shall not require prior authorization.
535	535	526 SECTION 14. Chapter 176B of the General Laws is hereby amended by inserting after
536	536	527section 4VV the following 2 sections:-
537	537	528 Section 4WW. (a) Any subscription certificate under an individual or group medical
538	538	529service agreement delivered, issued or renewed within the commonwealth, shall provide
539	539	530coverage for prescribed or dispensed opioid antagonists, as defined in section 19B of chapter
540	540	53194C and used in the reversal of overdoses caused by opioids, which shall not require prior
541	541	532authorization; provided, however, that a prescription from a health care practitioner shall not be
542	542	533required for coverage of opioid antagonists. An opioid antagonist used in the reversal of
543	543	534overdoses caused by opioids shall not be subject to any deductible, coinsurance, copayments or
544	544	535out-of-pocket limits; provided, however, that cost-sharing shall be required if the applicable plan
545	545	536is governed by the Internal Revenue Code and would lose its tax-exempt status as a result of the
546	546	537prohibition on cost-sharing for this service. 26 of 31
547	547	538 (b) The policy, contract, agreement, plan or certificate of insurance shall provide
548	548	539coverage for an opioid antagonist used in the reversal of overdoses caused by opioids as a
549	549	540medical benefit when dispensed by the health care facility in which the opioid antagonist was
550	550	541prescribed and shall provide coverage as a pharmacy benefit for an opioid antagonist used in the
551	551	542reversal of overdoses caused by opioids dispensed by a pharmacist, including an opioid
552	552	543antagonist dispensed pursuant to section 19B of chapter 94C; provided, however, that the rate to
553	553	544be reimbursed under the medical benefit shall not exceed the carrier’s average in-network
554	554	545pharmacy benefit rate and the health care facility shall not balance bill the patient.
555	555	546 Section 4XX. Any subscription certificate under an individual or group medical service
556	556	547agreement delivered, issued or renewed within the commonwealth shall provide coverage for the
557	557	548provision of services by a recovery coach licensed or otherwise authorized to practice under
558	558	549chapter 111J, irrespective of the setting in which these services are provided; provided, however,
559	559	550that such services shall be within the lawful scope of practice of a recovery coach. The
560	560	551contractual rate for these services shall be not less than the prevailing MassHealth rate for
561	561	552recovery coach services. The benefits in this section shall not be subject to any deductible,
562	562	553coinsurance, copayments or out-of-pocket limits; provided, however, that cost-sharing shall be
563	563	554required if the applicable plan is governed by the Internal Revenue Code and would lose its tax-
564	564	555exempt status as a result of the prohibition on cost-sharing for this service. Recovery coach
565	565	556services shall not require prior authorization.
566	566	557 SECTION 15. Chapter 176G of the General Laws is hereby amended by inserting after
567	567	558section 4NN the following 2 sections:- 27 of 31
568	568	559 Section 4OO. (a) An individual or group health maintenance contract that is issued or
569	569	560renewed within or without the commonwealth shall provide coverage for prescribed or dispensed
570	570	561opioid antagonists, as defined in section 19B of chapter 94C and used in the reversal of
571	571	562overdoses caused by opioids, which shall not require prior authorization; provided, however, that
572	572	563a prescription from a health care practitioner shall not be required for coverage of opioid
573	573	564antagonists. An opioid antagonist used in the reversal of overdoses caused by opioids shall not be
574	574	565subject to any deductible, coinsurance, copayments or out-of-pocket limits; provided, however,
575	575	566that cost-sharing shall be required if the applicable plan is governed by the Internal Revenue
576	576	567Code and would lose its tax-exempt status as a result of the prohibition on cost-sharing for this
577	577	568service.
578	578	569 (b) The individual or group health maintenance contract shall provide coverage for an
579	579	570opioid antagonist used in the reversal of overdoses caused by opioids as a medical benefit when
580	580	571dispensed by the health care facility in which the opioid antagonist was prescribed and shall
581	581	572provide coverage as a pharmacy benefit for an opioid antagonist used in the reversal of
582	582	573overdoses caused by opioids dispensed by a pharmacist, including an opioid antagonist
583	583	574dispensed pursuant to section 19B of chapter 94C; provided, however, that the rate to be
584	584	575reimbursed under the medical benefit shall not exceed the carrier’s average in-network pharmacy
585	585	576benefit rate and the health care facility shall not balance bill the patient.
586	586	577 Section 4PP. An individual or group health maintenance contract that is issued or
587	587	578renewed within or without the commonwealth shall provide coverage for the provision of
588	588	579services by a recovery coach licensed or otherwise authorized to practice under chapter 111J,
589	589	580irrespective of the setting in which these services are provided; provided, however, that such
590	590	581services shall be within the lawful scope of practice of a recovery coach. The contractual rate for 28 of 31
591	591	582these services shall be not less than the prevailing MassHealth rate for recovery coach services.
592	592	583The benefits in this section shall not be subject to any deductible, coinsurance, copayments or
593	593	584out-of-pocket limits; provided, however, that cost-sharing shall be required if the applicable plan
594	594	585is governed by the Internal Revenue Code and would lose its tax-exempt status as a result of the
595	595	586prohibition on cost-sharing for this service. Recovery coach services shall not require prior
596	596	587authorization.
597	597	588 SECTION 16. A “Certified Addictions Recovery Coach (CARC)” certification issued by
598	598	589the Massachusetts Board of Substance Abuse Counselor Certification or other comparable
599	599	590certifying body shall serve as satisfactory proof for recovery coach application requirements,
600	600	591including test exemptions, for a limited period following the effective date of this act as
601	601	592determined by the department of public health; provided, however, that the department shall
602	602	593waive the lived experience requirement for a recovery coach license pursuant to section 1 of
603	603	594chapter 111J of the General Laws for an applicant who was credentialed by the Massachusetts
604	604	595Board of Substance Abuse Counselor Certification prior to the effective date of this act. The
605	605	596eligible applicants shall meet all other qualifications and requirements for licensure as
606	606	597determined by the department. The department shall promulgate rules and regulations for the
607	607	598implementation of this section.
608	608	599 SECTION 17. (a) The department of public health shall study sober homes in the
609	609	600commonwealth, including the safety and recovery of sober home residents. The study shall
610	610	601include, but not be limited to: (i) appropriate training for operators and staff of sober homes and
611	611	602whether such training should be required; (ii) evidence-based methods to creating safe and health
612	612	603recovery environments; (iii) current oversight and additional oversight needed for sober homes;
613	613	604(iv) barriers to sober home facility improvements, including, but not limited to, fiscal constraints; 29 of 31
614	614	605and (v) different aspects, if any, between certified and noncertified sober homes. The department
615	615	606shall hold at least 1 public hearing as part of its study under this section.
616	616	607 (b) The department shall submit a report detailing the results of the study, along with
617	617	608recommendations and any proposed legislation necessary to carry out its recommendations, to
618	618	609the clerks of the senate and house of representatives, the joint committee on health care
619	619	610financing, the joint committee on public health, the joint committee on mental health, substance
620	620	611use and recovery and the senate and house committees on ways and means not later than July 31,
621	621	6122025.
622	622	613 SECTION 18. (a) There shall be a special commission to study prescribing practices for
623	623	614benzodiazepines and non-benzodiazepine hypnotics.
624	624	615 (b) The commission shall meet not less than 4 times and shall invite the public and
625	625	616medical experts in the field to offer testimony. The commission shall study and make
626	626	617recommendations on topics including, but not limited to: (i) current and best prescribing
627	627	618practices for benzodiazepines and non-benzodiazepine hypnotics; (ii) proper labeling of
628	628	619benzodiazepines and non-benzodiazepine hypnotics; and (iii) protocols to safely discontinue the
629	629	620use of benzodiazepines and non-benzodiazepine hypnotics and minimize the patient’s symptoms
630	630	621of withdrawal.
631	631	622 (c) The commission shall consist of: the commissioner of public health or a designee,
632	632	623who shall serve as chair; the secretary of health and human services or a designee; 4 members to
633	633	624be appointed by the governor, 1 of whom shall be a psychiatrist licensed to practice in the
634	634	625commonwealth, 1 of whom shall be a representative from the bureau of substance abuse services, 30 of 31
635	635	6261 of whom shall be a representative from the Center for Addiction Medicine at Massachusetts
636	636	627General Hospital and 1 of whom shall be an advocate from the addiction treatment community.
637	637	628 (d) The commission shall report its findings and recommendations, including any
638	638	629proposed legislation, to the clerks of the senate and the house of representatives, the joint
639	639	630committee on mental health, substance use and recovery and the senate and house committees on
640	640	631ways and means not later than 1 year after the commission’s first meeting.
641	641	632 SECTION 19. (a) The bureau of substance use addiction services shall conduct a study
642	642	633on the potential benefits of expanding collaborative practice agreements between physicians and
643	643	634pharmacists to allow for the prescription of schedule II to VI, inclusive, controlled substances by
644	644	635pharmacists outside of the hospital or health care institution setting to treat patients with
645	645	636substance use disorders.
646	646	637 (b) The bureau shall study and report on: (i) collaborative practice agreements between
647	647	638physicians and pharmacists for the prescription of substances in collaborative practice
648	648	639agreements in other states; and (ii) the positive and negative impacts of allowing a collaborative
649	649	640practice agreement for schedule II to VI, inclusive, controlled substances.
650	650	641 (c) The department shall submit a report detailing the results of the study, along with
651	651	642recommendations and any proposed legislation necessary to carry out its recommendations, to
652	652	643the clerks of the senate and house of representatives, the joint committee on mental health,
653	653	644substance use and recovery, the joint committee on public health and the senate and house
654	654	645committees on ways and means not later than January 1, 2025.
655	655	646 SECTION 20. The department of public health shall issue regulations pursuant to section
656	656	6477 not later than 6 months after the effective date of this act. 31 of 31
657	657	648 SECTION 21. Sections 1, 9, 10, 13, 14 and 15 shall take effect 6 months after the
658	658	649effective date of this act.
659	659	650 SECTION 22. No person shall be found to have violated section 4 of chapter 111J of the
660	660	651General Laws until 6 months after the department of public health first establishes a recovery
661	661	652coach license pursuant to section 2 of said chapter 111J.