Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1309 Compare Versions

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

Old	New	Differences
1	1	1 of 1
2	2	HOUSE DOCKET, NO. 538 FILED ON: 1/9/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1309
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Lindsay N. Sabadosa
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 assuring prompt access to health care.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Lindsay N. Sabadosa1st Hampshire1/9/2025 1 of 3
16	16	HOUSE DOCKET, NO. 538 FILED ON: 1/9/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 1309
18	18	By Representative Sabadosa of Northampton, a petition (accompanied by bill, House, No. 1309)
19	19	of Lindsay N. Sabadosa relative to reimbursements of costs for medically appropriate
20	20	evaluations and management services in outpatient settings. Financial Services.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Fourth General Court
24	24	(2025-2026)
25	25	_______________
26	26	An Act assuring prompt access to health care.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Chapter 32A of the General Laws is hereby amended by adding at the end
30	30	2the following new section:
31	31	3 Section 28: Reimbursement of costs for medically appropriate evaluation and
32	32	4management services in outpatient settings, including but not limited to office- and hospital-
33	33	5based clinics, in accordance with guidelines developed by the division of insurance, shall be part
34	34	6of a basic benefits package offered by the insurer or a third party and shall not require a
35	35	7deductible; provided, however, that deductibles shall be required if the applicable plan is
36	36	8governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
37	37	9of the prohibition on deductibles for these services.
38	38	10 SECTION 2. Chapter 32B of the General Laws is hereby amended by adding at the end
39	39	11the following new section: 2 of 3
40	40	12 Section 30: Reimbursement of costs for medically appropriate evaluation and
41	41	13management services in outpatient settings, including but not limited to office- and hospital-
42	42	14based clinics, in accordance with guidelines developed by the division of insurance, shall be part
43	43	15of a basic benefits package offered by the insurer or a third party and shall not require a
44	44	16deductible; provided, however, that deductibles shall be required if the applicable plan is
45	45	17governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
46	46	18of the prohibition on deductibles for these services.
47	47	19 SECTION 3. Chapter 175 of the General Laws is hereby amended by inserting the
48	48	20following section:-
49	49	21 Section 47LL: Reimbursement of costs for medically appropriate evaluation and
50	50	22management services in outpatient settings, including but not limited to office- and hospital-
51	51	23based clinics, in accordance with guidelines developed by the division of insurance, shall be part
52	52	24of a basic benefits package offered by the insurer or a third party and shall not require a
53	53	25deductible; provided, however, that deductibles shall be required if the applicable plan is
54	54	26governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
55	55	27of the prohibition on deductibles for these services.
56	56	28 SECTION 4. Chapter 176A of the General Laws is hereby amended by inserting the
57	57	29following section:-
58	58	30 Section 8NN: Reimbursement of costs for medically appropriate evaluation and
59	59	31management services in outpatient settings, including but not limited to office- and hospital-
60	60	32based clinics, in accordance with guidelines developed by the division of insurance, shall be part
61	61	33of a basic benefits package offered by the insurer or a third party and shall not require a 3 of 3
62	62	34deductible; provided, however, that deductibles shall be required if the applicable plan is
63	63	35governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
64	64	36of the prohibition on deductibles for these services.
65	65	37 SECTION 5. Chapter 176B of the General Laws is hereby amended by inserting the
66	66	38following section:-
67	67	39 Section 4NN: Reimbursement of costs for medically appropriate evaluation and
68	68	40management services in outpatient settings, including but not limited to office- and hospital-
69	69	41based clinics, in accordance with guidelines developed by the division of insurance, shall be part
70	70	42of a basic benefits package offered by the insurer or a third party and shall not require a
71	71	43deductible; provided, however, that a deductible shall be required if the applicable plan is
72	72	44governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
73	73	45of the prohibition on deductibles for these services.
74	74	46 SECTION 6. Chapter 176G of the General Laws is hereby amended by inserting the
75	75	47following new section 33:-
76	76	48 Section 33: Reimbursement of costs for medically appropriate evaluation and
77	77	49management services in outpatient settings, including but not limited to office- and hospital-
78	78	50based clinics, in accordance with guidelines developed by the division of insurance, shall be part
79	79	51of a basic benefits package offered by the insurer or a third party and shall not require a
80	80	52deductible; provided, however, that a deductible shall be required if the applicable plan is
81	81	53governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result
82	82	54of the prohibition on deductibles for these services.