Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1358 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. 2117 FILED ON: 1/15/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1358
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Marjorie C. Decker
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 advancing health care research and decision-making centered on patients and people with
13	13	disabilities.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :DATE ADDED:Marjorie C. Decker25th Middlesex1/15/2025 1 of 4
17	17	HOUSE DOCKET, NO. 2117 FILED ON: 1/15/2025
18	18	HOUSE . . . . . . . . . . . . . . . No. 1358
19	19	By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 1358) of
20	20	Marjorie C. Decker relative to health care research and decision-making centered on patients and
21	21	persons with disabilities. Health Care Financing.
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Fourth General Court
25	25	(2025-2026)
26	26	_______________
27	27	An Act advancing health care research and decision-making centered on patients and people with
28	28	disabilities.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Chapter 118E of the General Laws is hereby amended by adding the
32	32	2following section:
33	33	3 Section 80: Patient-Centeredness
34	34	4 Section 80 (a) Standards for Patient-Centeredness in Research & Analysis. The Division
35	35	5of Medical Assistance shall ensure that any portfolio of research and analysis relied upon for
36	36	6decision-making, whether provided by a state agency or a third party, impacting enrollee access
37	37	7to healthcare treatments and services, meets standards of patient-centeredness. The Division of
38	38	8Medical Assistance shall publicly provide a summary of patient-centeredness standards for any
39	39	9such analysis that includes, but is not limited to:
40	40	10 1) Evaluation of a range of research and analysis that includes outcomes prioritized by
41	41	11patients and people with disabilities within a specific disease area. If necessary, the Division of 2 of 4
42	42	12Medical Assistance will commission a survey of patients to identify relevant outcomes within a
43	43	13disease area.
44	44	14 2) Evaluation of a range of research and analysis that looks at relevant patient subgroups
45	45	15to ensure consideration of important differences in preferences and clinical characteristics within
46	46	16patient subpopulations.
47	47	17 3) Scientific Rigor: The Division of Medical Assistance shall require research and
48	48	18analysis to comply with good research practices, defined as consideration of the full range of
49	49	19relevant, peer-reviewed evidence (e.g., real-world evidence, research from range of sponsors
50	50	20including manufacturers), avoid patient harm through over-interpretation of findings of
51	51	21“inconclusive” evidence of clinical differences and instead allow time for conduct of additional
52	52	22research.
53	53	23 (b) Prohibition on Reliance on Discriminatory Measures. The Division of Medical
54	54	24Assistance shall not develop or utilize, directly or indirectly through a contracted entity or other
55	55	25third-party, a dollars-per-quality adjusted life year or any similar measures or research in
56	56	26determining whether a particular health care treatment is cost effective, recommended, the value
57	57	27of a treatment, or in determining coverage, reimbursement, appropriate payment amounts, cost-
58	58	28sharing, or incentive policies or programs.
59	59	29 (c) Appeals and Physician Override Mechanisms. The Division of Medical Assistance
60	60	30may not implement any policy limiting patient access to healthcare treatment and services which
61	61	31does not contain an appeals or physician override mechanism. Physicians may not be
62	62	32discriminated against or otherwise negatively impacted for utilizing available physician override
63	63	33mechanisms. 3 of 4
64	64	34 SECTION 2. Chapter 6D of the General Laws is hereby amended by adding the
65	65	35following section:
66	66	36 Section 20. Patient-Centeredness Standards for Health Policy Commission Reviews
67	67	37 Section 20 (a) Standards for Patient-Centeredness in Research & Analysis. The Health
68	68	38Policy Commission shall ensure that any portfolio of research and analysis relied upon for
69	69	39determining the value of a healthcare treatment or service , whether provided by a state agency
70	70	40or a third party, impacting enrollee access to healthcare treatments and services, meets standards
71	71	41of patient-centeredness. The Health Policy Commission shall publicly provide a summary of
72	72	42patient-centeredness standards for any such analysis that includes, but is not limited to:
73	73	43 1) Evaluation of a range of research and analysis that includes outcomes prioritized by
74	74	44patients and people with disabilities within a specific disease area. If necessary, the Health Policy
75	75	45Commission will commission a survey of patients to identify relevant outcomes within a disease
76	76	46area.
77	77	47 2) Evaluation of a range of research and analysis that looks at relevant patient subgroups
78	78	48to ensure consideration of important differences in preferences and clinical characteristics within
79	79	49patient subpopulations.
80	80	50 3) Scientific Rigor: The Health Policy Commission shall require research and analysis to
81	81	51comply with good research practices, defined as consideration of the full range of relevant, peer-
82	82	52reviewed evidence (e.g., real-world evidence, research from range of sponsors including
83	83	53manufacturers), avoid patient harm through over-interpretation of findings of “inconclusive”
84	84	54evidence of clinical differences and instead allow time for conduct of additional research. 4 of 4
85	85	55 (b) Prohibition on Reliance on Discriminatory Measures. The Health Policy Commission
86	86	56shall not develop or utilize, directly or indirectly through a contracted entity or other third-party,
87	87	57a dollars-per-quality adjusted life year or any similar measures or research in determining
88	88	58whether a particular health care treatment is cost effective, recommended, the value of a
89	89	59treatment, or in determining coverage, reimbursement, appropriate payment amounts, cost-
90	90	60sharing, or incentive policies or programs.