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