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HOUSE DOCKET, NO. 914 FILED ON: 1/14/2025
HOUSE . . . . . . . . . . . . . . . No. 1168
The Commonwealth of Massachusetts
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PRESENTED BY:
Judith A. Garcia
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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 relative to eliminating the PCP referral requirement for specialty gynecological care.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Judith A. Garcia11th Suffolk1/14/2025Patrick Joseph Kearney4th Plymouth1/22/2025 1 of 1
HOUSE DOCKET, NO. 914 FILED ON: 1/14/2025
HOUSE . . . . . . . . . . . . . . . No. 1168
By Representative Garcia of Chelsea, a petition (accompanied by bill, House, No. 1168) of
Judith A. Garcia and Patrick Joseph Kearney relative to eliminating the health insurance referral
requirement for certain specialty gynecological care. Financial Services.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Fourth General Court
(2025-2026)
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An Act relative to eliminating the PCP referral requirement for specialty gynecological care.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 Subsection (g) of section 15 of chapter 176O of the General Laws, as appearing in the
22022 Official Edition, is hereby amended by striking out the first sentence and inserting in place
3thereof the following sentence:- No carrier shall require an insured to obtain a referral or prior
4authorization from a primary care provider for specialty care provided by an obstetrician,
5gynecologist, certified nurse-midwife or family practitioner participating in such carrier's health
6care provider network for the following: (i) annual preventive gynecologic health examinations,
7including any subsequent obstetric or gynecological services determined by such obstetrician,
8gynecologist, certified nurse-midwife or family practitioner to be medically necessary as a result
9of such examination; (ii) preventative gynecologic health care and menstrual health conditions
10such as abnormal uterine bleeding, dysmenorrhea and pelvic pain; (iii) maternity care; and (iv)
11medically necessary evaluations and resultant health care services for acute or emergency
12gynecological conditions.