Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S730 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 2117 FILED ON: 1/20/2023
3	3	SENATE . . . . . . . . . . . . . . No. 730
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Brendan P. Crighton
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act advancing health care research and decision-making centered on patients and people with
13	13	disabilities.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :Brendan P. CrightonThird Essex 1 of 4
17	17	SENATE DOCKET, NO. 2117 FILED ON: 1/20/2023
18	18	SENATE . . . . . . . . . . . . . . No. 730
19	19	By Mr. Crighton, a petition (accompanied by bill, Senate, No. 730) of Brendan P. Crighton for
20	20	legislation to advance health care research and decision-making centered on patients and people
21	21	with disabilities. Health Care Financing.
22	22	[SIMILAR MATTER FILED IN PREVIOUS SESSION
23	23	SEE SENATE, NO. 753 OF 2021-2022.]
24	24	The Commonwealth of Massachusetts
25	25	_______________
26	26	In the One Hundred and Ninety-Third General Court
27	27	(2023-2024)
28	28	_______________
29	29	An Act advancing health care research and decision-making centered on patients and people with
30	30	disabilities.
31	31	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
32	32	of the same, as follows:
33	33	1 SECTION 1. Chapter 118E: DIVISION OF MEDICAL ASSISTANCE of the
34	34	2Massachusetts General Laws, as appearing in the 2018 Official Edition, is hereby amended by
35	35	3adding the following section:
36	36	4 Section 79: Patient-Centeredness
37	37	5 Section 79 (a) Standards for Patient-Centeredness in Research & Analysis. The Division
38	38	6of Medical Assistance shall ensure that any portfolio of research and analysis relied upon for
39	39	7decision-making, whether provided by a state agency or a third party, impacting enrollee access
40	40	8to healthcare treatments and services, meets standards of patient-centeredness. The Division of 2 of 4
41	41	9Medical Assistance shall publicly provide a summary of patient-centeredness standards for any
42	42	10such analysis that includes, but is not limited to:
43	43	11 1) Evaluation of a range of research and analysis that includes outcomes prioritized by
44	44	12patients and people with disabilities within a specific disease area. If necessary, the Division of
45	45	13Medical Assistance will commission a survey of patients to identify relevant outcomes within a
46	46	14disease area.
47	47	15 2) Evaluation of a range of research and analysis that looks at relevant patient subgroups
48	48	16to ensure consideration of important differences in preferences and clinical characteristics within
49	49	17patient subpopulations.
50	50	18 3) Scientific Rigor: The Division of Medical Assistance shall require research and
51	51	19analysis to comply with good research practices, defined as consideration of the full range of
52	52	20relevant, peer-reviewed evidence (e.g., real-world evidence, research from range of sponsors
53	53	21including manufacturers), avoid patient harm through over-interpretation of findings of
54	54	22“inconclusive” evidence of clinical differences and instead allow time for conduct of additional
55	55	23research.
56	56	24 (b) Prohibition on Reliance on Discriminatory Measures. The Division of Medical
57	57	25Assistance shall not develop or utilize, directly or indirectly through a contracted entity or other
58	58	26third-party, a dollars-per-quality adjusted life year or any similar measures or research in
59	59	27determining whether a particular health care treatment is cost effective, recommended, the value
60	60	28of a treatment, or in determining coverage, reimbursement, appropriate payment amounts, cost-
61	61	29sharing, or incentive policies or programs. 3 of 4
62	62	30 (c) Appeals and Physician Override Mechanisms. The Division of Medical Assistance
63	63	31may not implement any policy limiting patient access to healthcare treatment and services which
64	64	32does not contain an appeals or physician override mechanism. Physicians may not be
65	65	33discriminated against or otherwise negatively impacted for utilizing available physician override
66	66	34mechanisms.
67	67	35 SECTION 2. Title II, Chapter 6D of the General Laws, as appearing in the 2018 Official
68	68	36Edition, is hereby amended by adding the following section:
69	69	37 Section 20. Patient-Centeredness Standards for Health Policy Commission Reviews
70	70	38 Section 20 (a) Standards for Patient-Centeredness in Research & Analysis. The Health
71	71	39Policy Commission shall ensure that any portfolio of research and analysis relied upon for
72	72	40determining the value of a healthcare treatment or service , whether provided by a state agency
73	73	41or a third party, impacting enrollee access to healthcare treatments and services, meets standards
74	74	42of patient-centeredness. The Health Policy Commission shall publicly provide a summary of
75	75	43patient-centeredness standards for any such analysis that includes, but is not limited to:
76	76	44 1) Evaluation of a range of research and analysis that includes outcomes prioritized by
77	77	45patients and people with disabilities within a specific disease area. If necessary, the Health Policy
78	78	46Commission will commission a survey of patients to identify relevant outcomes within a disease
79	79	47area.
80	80	48 2) Evaluation of a range of research and analysis that looks at relevant patient subgroups
81	81	49to ensure consideration of important differences in preferences and clinical characteristics within
82	82	50patient subpopulations. 4 of 4
83	83	51 3) Scientific Rigor: The Health Policy Commission shall require research and analysis to
84	84	52comply with good research practices, defined as consideration of the full range of relevant, peer-
85	85	53reviewed evidence (e.g., real-world evidence, research from range of sponsors including
86	86	54manufacturers), avoid patient harm through over-interpretation of findings of “inconclusive”
87	87	55evidence of clinical differences and instead allow time for conduct of additional research.
88	88	56 (b) Prohibition on Reliance on Discriminatory Measures. The Health Policy Commission
89	89	57shall not develop or utilize, directly or indirectly through a contracted entity or other third-party,
90	90	58a dollars-per-quality adjusted life year or any similar measures or research in determining
91	91	59whether a particular health care treatment is cost effective, recommended, the value of a
92	92	60treatment, or in determining coverage, reimbursement, appropriate payment amounts, cost-
93	93	61sharing, or incentive policies or programs.