Massachusetts 2025 2025-2026 Regular Session

Massachusetts House Bill H1315 Introduced / Bill

Filed 02/27/2025

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HOUSE DOCKET, NO. 3884       FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1315
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 relative to IUD pain management coverage.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Lindsay N. Sabadosa1st Hampshire1/17/2025Rebecca L. RauschNorfolk, Worcester and Middlesex1/22/2025Samantha Montaño15th Suffolk2/3/2025Danillo A. Sena37th Middlesex2/5/2025John H. Rogers12th Norfolk2/5/2025Marjorie C. Decker25th Middlesex2/14/2025Erika Uyterhoeven27th Middlesex2/19/2025Natalie M. Higgins4th Worcester2/24/2025Manny Cruz7th Essex2/25/2025James C. Arena-DeRosa8th Middlesex3/1/2025 1 of 8
HOUSE DOCKET, NO. 3884       FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1315
By Representative Sabadosa of Northampton, a petition (accompanied by bill, House, No. 1315) 
of Lindsay N. Sabadosa and others relative to IUD pain management coverage. Financial 
Services.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act relative to IUD pain management coverage.
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, as appearing in the 2022 official edition, 
2is hereby amended by inserting after Section 28(h) the following section:
3 Section 28. (i) Any coverage offered by the commission to any active or retired employee 
4of the commonwealth insured under the group insurance commission shall provide coverage for 
5pain control methods during intrauterine device insertion, including but not limited to 
6intravenous sedation, oral sedation, nitrous oxide, local anesthesia, or topical anesthesia as 
7prescribed by a provider, acting within their scope of practice.
8 (j) (1) Coverage provided under subjection (g) shall not be subject to any deductible, 
9coinsurance, copayment or any other cost-sharing requirement, except as provided for in 
10subclauses (A) and (B) of clause (i) of subsection (a) or as otherwise required under federal law. 
11Coverage offered under this section shall not impose unreasonable restrictions or delays in the  2 of 8
12coverage; provided, however, that reasonable medical management techniques may be applied to 
13coverage within a method category, as defined by the FDA, but not across types of methods.
14 (2) Benefits for an enrollee under this section 	shall also be provided for such enrollee’s 
15covered spouse and covered dependents.
16 (3) Nothing in this section shall be construed to deny or restrict in any way the group 
17insurance commission’s authority to ensure plan compliance with this chapter.
18 SECTION 2. Chapter 118E of the General Laws, as appearing in the 2022 official 
19edition, is hereby amended by inserting in section 10K the following subsections:
20 (g) The division and its contracted health insurers, health plans, health maintenance 
21organizations, behavioral health management firms and third-party administrators under contract 
22to a Medicaid managed care organization or primary care clinician plan shall provide coverage 
23for pain control methods during interuterine device insertion, including but not limited to 
24intravenous sedation, oral sedation, nitrous oxide, local anesthesia, or topical anesthesia as 
25prescribed by a provider, acting within their scope of practice.
26 (h) (1) Coverage provided under subjection (g) shall not be subject to any deductible, 
27coinsurance, copayment or any other cost-sharing requirement, except as provided for in 
28subclauses (A) and (B) of clause (i) of subsection (a) or as otherwise required under federal law. 
29Coverage provided under this section shall not impose unreasonable restrictions or delays in the 
30coverage; provided, however, that reasonable medical management techniques may be applied to 
31coverage within a method category, as defined by the FDA, but not across types of methods. 3 of 8
32 (2) Benefits for an enrollee under this section 	shall be the same for such enrollee’s 
33covered spouse and covered dependents.
34 (3) Nothing in this section shall be construed to deny or restrict in any way the division of 
35medical assistance’s authority to ensure its contracted health insurers, health plans, health 
36maintenance organizations, behavioral health management firms and third-party administrators 
37under contract to a Medicaid managed care organization or primary care clinician plan are in 
38compliance with this chapter.
39 SECTION 3. Chapter 175 of the General Laws, as appearing in the 2022 official edition, 
40is hereby amended by inserting after section 47W(j) the following subsections:
41 (k) An individual policy of accident and sickness insurance issued pursuant to section 
42108 that provides hospital expense and surgical expense and any group blanket policy of accident 
43and sickness insurance issued pursuant to section 110 that provides hospital expense and surgical 
44expense insurance, delivered, issued or renewed by agreement between the insurer and the 
45policyholder, within or without the Commonwealth, (hereinafter “policy”) shall provide benefits 
46for residents of the Commonwealth and all group members having a principal place of 
47employment within the Commonwealth coverage for pain control methods during interuterine 
48device insertion, including but not limited to intravenous sedation, oral sedation, nitrous oxide, 
49local anesthesia, or topical anesthesia as prescribed by a provider, acting within their scope of 
50practice.
51 (l) (1) Coverage provided under subsection (k) shall not be subject to any deductible, 
52coinsurance, copayment or any other cost-sharing requirement, except as provided for in 
53subclauses (A) and (B) of clause (i) of subsection (d) or as otherwise required under federal law.  4 of 8
54Coverage offered under said subsection (d) shall not impose unreasonable restrictions or delays 
55in the coverage, in accordance with the requirements of chapter 176O; provided, however, that 
56reasonable medical management techniques may be applied to coverage within a method 
57category, as defined by the FDA, but not across types of methods.
58 (2) Benefits for an enrollee shall be the same for such enrollee’s covered spouse and 
59covered dependents.
60 (m) A policy of accident and sickness insurance that is purchased by an employer that is a 
61church or qualified church-controlled organization shall be exempt from subsection (k) at the 
62request of the employer.
63 (n) The commissioner of insurance shall ensure that plans issued under subsection (k) 
64comply with this chapter.
65 (o) For purposes of this section, the definitions in subsection (j) apply.
66 SECTION 4. Chapter 176A of the General Laws, as appearing in the 2022 official 
67edition, is hereby amended by inserting after section 8W(j) the following subsections:
68 (k) Any contract between a subscriber and the corporation under an individual or group 
69hospital service plan that is delivered, issued or renewed within or without the Commonwealth 
70and that provides benefits for outpatient services shall provide to all individual subscribers and 
71members within the Commonwealth and to all group members having a principal place of 
72employment within the Commonwealth coverage for pain control methods during interuterine 
73device insertion, including but not limited to intravenous sedation, oral sedation, nitrous oxide,  5 of 8
74local anesthesia, or topical anesthesia as prescribed by a provider, acting within their scope of 
75practice.
76 (l) Coverage provided under subsection (k) shall not be subject to any deductible, 
77coinsurance, copayment or any cost-sharing requirement except as provided for in subclauses 
78(A) and (B) of clause (i) of subsection (d) or as otherwise required under federal law. Coverage 
79offered under subsection (k) shall not impose any unreasonable restriction or delay in the 
80coverage, in accordance with the requirements of chapter 176O; provided, however, that 
81reasonable medical management techniques may be applied to coverage within a method 
82category, as defined by the FDA, but not across types of methods.
83 (m) (1) The requirements of subsection (k) shall not apply to a contract between a 
84subscriber and a corporation under an individual or group hospital service plan that is delivered, 
85issued, or renewed within or without the Commonwealth that is purchased by an employer that is 
86a church or qualified church-controlled organization.
87 (2) A church or qualified church-controlled organization that invokes the exemption 
88provided under subsection (m)(1) shall provide written notice to prospective enrollees prior to 
89enrollment with the plan, listing the contraceptive health care methods and services such 
90employer refuses to cover for religious reasons.
91 (n) Nothing in this subsection shall be construed to deny or restrict in any way the 
92division of insurance’s authority to ensure contract compliance with this chapter.
93 (o) For purposes of this section, the definitions set forth in section (j) of this Chapter shall 
94apply, unless the context clearly requires otherwise. 6 of 8
95 SECTION 5. Chapter 176B of the General Laws, as appearing in the 2022 official 
96edition, is hereby amended by inserting after section 4W(j) the following subsections:
97 (k) Any subscription certificate under an individual or group medical service agreement 
98that is delivered, issued or renewed within or without the Commonwealth and that provides 
99benefits for outpatient services shall provide to all individual subscribers and members within the 
100Commonwealth and to all group members having a principal place of employment within the 
101Commonwealth coverage for all of the following services and contraceptive methods for pain 
102control methods during intrauterine device insertion, including but not limited to intravenous 
103sedation, oral sedation, nitrous oxide, local anesthesia, or topical anesthesia as prescribed by a 
104provider, acting within their scope of practice.
105 (l) (1) A medical service agreement subject to subsection (k) shall not impose a 
106deductible, coinsurance, copayment or any other cost-sharing requirement on the coverage 
107provided.
108 (2) Benefits for an enrollee under this subsection shall be the same for such enrollee’s 
109covered spouse and covered dependents.
110 (m) (1) The requirements of this subsection shall not apply to a medical service 
111agreement that is delivered, issued, or renewed within or without the Commonwealth that is 
112purchased by an employer that is a church or qualified church-controlled organization.
113 (2) A church or qualified church-controlled organization that invokes the exemption 
114provided under subsection (m)(1) shall provide written notice to prospective enrollees prior to 
115enrollment with the plan, listing the contraceptive health care methods and services the employer 
116refuses to cover for religious reasons. 7 of 8
117 (n) Nothing in this subsection shall be construed to deny or restrict in any way the 
118division of insurance’s authority to ensure medical service agreement compliance with this 
119chapter.
120 (o) For purposes of this section, the definitions set forth in subsection (j) shall apply, 
121unless the context clearly requires otherwise.
122 SECTION 6. Chapter 176G of the General Laws, as appearing in the 2022 official 
123edition, is hereby amended by inserting after section 4O(c) the following subsections:
124 (d) Any individual or group health maintenance contract that is issued, renewed or 
125delivered within or without the Commonwealth and that provides benefits for outpatient 
126prescription drugs or devices shall provide to residents of the Commonwealth and to persons 
127having a principal place of employment within the Commonwealth coverage for pain control 
128methods during intrauterine device insertion, including but not limited to intravenous sedation, 
129oral sedation, nitrous oxide, local anesthesia, or topical anesthesia as prescribed by a provider, 
130acting within their scope of practice.
131 (e) (1) Coverage provided under subsection (d) shall not be subject to any deductible, 
132coinsurance, copayment or any other cost-sharing requirement except as provided for in 
133subclauses (A) and (B) of clause (i) of subsection (d) or otherwise as required under federal law. 
134Coverage offered under said subsection (d) shall not impose unreasonable restrictions or delays 
135in the coverage, in accordance with the requirements of chapter 176O; provided, however, that 
136reasonable medical management techniques may be applied to coverage within a method 
137category, as defined by the FDA, but not across types of methods. 8 of 8
138 (2) Benefits for an enrollee under this section 	shall be the same for such enrollee’s 
139covered spouse and covered dependents.
140 (f) (1) The requirements of this subsection shall not apply to a health maintenance 
141contract if that policy is purchased by an employer that is a church or qualified church-controlled 
142organization.
143 (2) A church or qualified church-controlled organization that invokes the exemption 
144provided under subsection (f)(1) shall provide written notice to prospective enrollees prior to 
145enrollment with the plan, listing the contraceptive health care services the employer refuses to 
146cover for religious reasons.
147 (g) Nothing in this subsection shall be construed to deny or restrict in any way the 
148division of insurance’s authority to ensure health maintenance contract compliance with this 
149chapter.
150 (h) For purposes of this section, the definitions in subjection (j) shall apply, unless the 
151context clearly requires otherwise.
152 SECTION 7. Sections 1 through 6 of this act shall apply to all policies, contracts and 
153certificates of health insurance subject to chapters 32A, chapter 118E, chapter 175, chapter 
154176A, chapter 176B, and chapter 176G which are delivered, issued or renewed on or after 
155September 1, 2026.