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