Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1406 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. 2860 FILED ON: 1/16/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1406
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 to improve continuity of care for MassHealth members with chronic conditions.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Lindsay N. Sabadosa1st Hampshire1/16/2025 1 of 2
16	16	HOUSE DOCKET, NO. 2860 FILED ON: 1/16/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 1406
18	18	By Representative Sabadosa of Northampton, a petition (accompanied by bill, House, No. 1406)
19	19	of Lindsay N. Sabadosa relative to continuity of care for MassHealth members with chronic
20	20	conditions. Health Care Financing.
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 to improve continuity of care for MassHealth members with chronic conditions.
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 118E of the General Laws is hereby amended by adding, before
30	30	2Chapter D, the following new section:
31	31	3 Section 9C1/2. Prior Authorization Requirements Related to Community-based Long-
32	32	4term Care for MassHealth Members with Chronic Conditions.
33	33	5 (1) For purposes of this section, the following terms shall have the following definitions:
34	34	6 “Community long-term care services” shall include, but is not limited to: Adult Day
35	35	7Health, Adult Foster Care, Group Adult Foster Care, Day Habilitation, Home Health Aide,
36	36	8Personal Care Attendant Services, and all services described in the Frail Elder Waiver that was in
37	37	9effect as of April 1, 2024, provided that these long-term care services include services itemized
38	38	10in the Frail Elder Waiver as well as said services included in any other 1915(c) waiver in effect
39	39	11as of April 1, 2024; 2 of 2
40	40	12 “Chronic condition” is a health condition or disease that is persistent or otherwise
41	41	13expected to last longer than one year; include intellectual or developmental disabilities.
42	42	14 (2) Where the agency requires prior authorization for long-term services and supports,
43	43	15prior authorization for long-term services and supports that address a chronic condition shall
44	44	16issue for the duration of the prescribed or ordered service for a prior authorization period of up to
45	45	17five (5) years.
46	46	18 Nothing in this section shall preclude MassHealth or its authorized agent from modifying
47	47	19a service plan at the request of the member or a primary care provider in response to a change in
48	48	20a member’s condition and their corresponding service need.
49	49	21 Section 2. Section 4B of Chapter 19A of the General Laws is hereby amended by adding,
50	50	22after the fourth paragraph, the following paragraph:
51	51	23 Regarding the service authorization duties enabled by paragraph one in this section,
52	52	24where a skilled medical provider employed by an ASAP conducts screening activities and
53	53	25service authorizations for community long-term care services for which the ASAP will not be the
54	54	26direct service provider, the service authorization shall constitute a prior authorization for
55	55	27community long-term care services. ASAPs shall work to promote the prompt delivery of
56	56	28services pursuant to a service plan. The provisions of this paragraph shall apply to the senior care
57	57	29options initiative established by section 9D of Chapter 118E. Nothing in this section shall
58	58	30preclude MassHealth or its authorized agent from modifying a service plan at the direction of the
59	59	31member or a primary care provider in response to a change in a member’s condition and their
60	60	32corresponding service need.