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