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HOUSE DOCKET, NO. 1364 FILED ON: 1/14/2025
HOUSE . . . . . . . . . . . . . . . No. 253
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Sally P. Kerans
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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 establishing guardians as providers of medical care to support the rights of incapacitated
persons.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Sally P. Kerans13th Essex1/14/2025Kathleen R. LaNatra12th Plymouth2/6/2025James C. Arena-DeRosa8th Middlesex2/20/2025Carlos González10th Hampden2/26/2025Vanna Howard17th Middlesex3/5/2025 1 of 4
HOUSE DOCKET, NO. 1364 FILED ON: 1/14/2025
HOUSE . . . . . . . . . . . . . . . No. 253
By Representative Kerans of Danvers, a petition (accompanied by bill, House, No. 253) of Sally
P. Kerans and others relative to establishing guardians as providers of medical care to support the
rights of incapacitated persons. Children, Families and Persons with Disabilities.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Fourth General Court
(2025-2026)
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An Act establishing guardians as providers of medical care to support the rights of incapacitated
persons.
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. Section 8 of chapter 118E of the General Laws is hereby amended by
2striking out paragraph (f) and inserting in place thereof the following paragraph:-
3 “Provider", includes any institution, agency, individual or other legal entity (i) qualified
4under the laws of the commonwealth to perform the medical care or services for which medical
5assistance and medical benefits are available under this chapter or (ii) that is duly appointed (or
6recognized, if appointed elsewhere) under the laws of the commonwealth as guardian of a
7member who is eligible for medical assistance under this chapter while engaged in activities that
8are reasonably related to consenting or gaining access to medical care or services for the
9member. Provided, however, that no person who is a spouse, parent, child, or sibling of the
10member (hereinafter, an “immediate family relationship”) shall be included in the definition of
11Provider herein. 2 of 4
12 SECTION 2. Section 13C of chapter 118E of the General Laws is hereby amended by
13striking out the second paragraph and inserting in its place the following paragraph:-
14 The secretary of the executive office shall establish rates of payment for social service
15programs which are reasonable and adequate to meet the costs which are incurred by efficiently
16and economically operated social service program providers in providing social service programs
17in conformity with federal and state law, regulations and quality and safety standards; provided,
18that the secretary may designate another governmental unit to perform such ratemaking
19functions. When establishing rates of payment for social service programs and guardians, the
20secretary of the executive office shall adjust rates to take into account factors, including, but not
21limited to: (i) the reasonable cost to social service program providers or guardians of any existing
22or new governmental mandate that has been enacted, promulgated or imposed by any branch of
23government, governmental unit or federal governmental authority; (ii) rates customarily charged
24by professional guardians in the region of the commonwealth; (iii) a cost adjustment factor to
25reflect changes in reasonable costs of goods and services of social service programs including
26 those attributed to inflation; and (iv) geographic differences in wages, benefits, housing
27and real estate costs in each metropolitan statistical area of the commonwealth and in any city or
28town therein where such costs are substantially higher than the average cost within that area as a
29whole. The secretary of the executive office shall not consider any of the resources specified in
30section 13G when establishing, reviewing or approving rates of payment for social service
31programs.
32 SECTION 3. Section 13D of chapter 118E of the General Laws is hereby amended by
33inserting the following paragraph after the seventh paragraph: 3 of 4
34 In establishing rates for medically-related services for which a guardian is considered a
35“Provider” under section 8 of this chapter, the secretary of the executive office shall (i)
36determine hourly or fee-for-service rates for professional guardians by considering the rates
37customarily charged by professional guardians in the region of the commonwealth.
38 SECTION 4. Section 35 of chapter 118E of the General Law is hereby amended by
39striking the first paragraph and inserting in place thereof the following paragraph:-
40 No claim for medical care or services provided for under this chapter shall be reimbursed
41if any health insurance company, non-profit hospital service corporation, medical service
42corporation, or other health insurer is liable for such claim under the terms of a group or
43individual policy providing coverage for such claim to a person eligible for assistance under this
44chapter; in the case of a guardian, no claim for care or services shall be reimbursed if any
45department of the state or federal judiciary is liable for such claim. The division shall establish
46procedures to ensure that no such unauthorized claims are paid, including the soliciting of
47information regarding alternative health coverage from all applicants and recipients.
48 SECTION 5. Said section 36 of chapter 118E of the General Law is hereby further
49amended by inserting after paragraph (5) the following paragraph:-
50 A claim submitted by a guardian that is paid for under this chapter shall be disclosed to
51the court that has appointed the guardian as part of the guardian’s annual report to the court;
52provided, however, that prior or subsequent judicial approval shall not be a condition or required
53as evidence of entitlement for reimbursement of any claim by a guardian that is submitted for
54services provided for under this chapter. 4 of 4
55 SECTION 6. Section 36 of chapter 118E of the General Laws is hereby amended by
56striking paragraph (1) and inserting in place thereof the following paragraph:
57 (1) indicate their intention to the division to so participate; provided that renewal of such
58indication of intention by a guardian shall not be required more often than once every 12 months;
59 SECTION 7. Section 36 of chapter 118E of the General Law is hereby amended by
60striking paragraph (2) and inserting in place thereof the following paragraph:-
61 (2) present evidence, satisfactory to the division, of their qualifications to provide such
62services. For guardians, satisfactory evidence of qualification shall consist of (i) a certificate of
63appointment dated within one year of the request for payment and a sworn statement of its
64validity on the dates of service; and (ii) affidavit of no immediate family relationship with the
65member.