1 of 1 SENATE DOCKET, NO. 1754 FILED ON: 1/16/2025 SENATE . . . . . . . . . . . . . . No. 465 The Commonwealth of Massachusetts _________________ PRESENTED BY: Sal N. DiDomenico _________________ 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 supporting individuals suffering with amyotrophic lateral sclerosis and their families. _______________ PETITION OF: NAME:DISTRICT/ADDRESS :Sal N. DiDomenicoMiddlesex and Suffolk 1 of 4 SENATE DOCKET, NO. 1754 FILED ON: 1/16/2025 SENATE . . . . . . . . . . . . . . No. 465 By Mr. DiDomenico, a petition (accompanied by bill, Senate, No. 465) of Sal N. DiDomenico for legislation to support individuals suffering with amyotrophic lateral sclerosis and their families. Elder Affairs. The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Fourth General Court (2025-2026) _______________ An Act supporting individuals suffering with amyotrophic lateral sclerosis and their families. 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. The executive office of elder affairs, under authority granted in section 4 of 2chapter 19A of Massachusetts general laws, shall amend the Massachusetts home care 3regulations (651 CMR 3.00). Such amendment shall require home care program services be 4made available to persons diagnosed with amyotrophic lateral sclerosis regardless of their age, if 5they are otherwise eligible for such services. The secretary for health and human services shall 6ensure that the relevant agencies under her purview promulgate regulations as necessary to 7implement this act. 8 SECTION 2. Chapter 118E: DIVISION OF MEDICAL ASSISTANCE of the 9Massachusetts General Laws, as appearing in the 2018 Official Edition, is hereby amended by 10adding the following section: 11 Section 79: Patient-Centeredness 2 of 4 12 Section 79 (a) Standards for Patient-Centeredness in Research & Analysis. The Division 13of Medical Assistance shall ensure that any portfolio of research and analysis relied upon for 14decision-making, whether provided by a state agency or a third party, impacting enrollee access 15to healthcare treatments and services, meets standards of patient-centeredness. The Division of 16Medical Assistance shall publicly provide a summary of patient-centeredness standards for any 17such analysis that includes, but is not limited to: 18 1) Evaluation of a range of research and analysis that includes outcomes prioritized by 19patients and people with disabilities within a specific disease area. If necessary, the Division of 20Medical Assistance will commission a survey of patients to identify relevant outcomes within a 21disease area. 22 2) Evaluation of a range of research and analysis that looks at relevant patient subgroups 23to ensure consideration of important differences in preferences and clinical characteristics within 24patient subpopulations. 25 3) Scientific Rigor: The Division of Medical Assistance shall require research and 26analysis to comply with good research practices, defined as consideration of the full range of 27relevant, peer-reviewed evidence (e.g., real-world evidence, research from range of sponsors 28including manufacturers), avoid patient harm through over-interpretation of findings of 29“inconclusive” evidence of clinical differences and instead allow time for conduct of additional 30research. 31 (b) Prohibition on Reliance on Discriminatory Measures. The Division of Medical 32Assistance shall not develop or utilize, directly or indirectly through a contracted entity or other 33third-party, a dollars-per-quality adjusted life year or any similar measures or research in 3 of 4 34determining whether a particular health care treatment is cost effective, recommended, the value 35of a treatment, or in determining coverage, reimbursement, appropriate payment amounts, cost- 36sharing, or incentive policies or programs. 37 (c) Appeals and Physician Override Mechanisms. The Division of Medical Assistance 38may not implement any policy limiting patient access to healthcare treatment and services which 39does not contain an appeals or physician override mechanism. Physicians may not be 40discriminated against or otherwise negatively impacted for utilizing available physician override 41mechanisms. 42 SECTION 3. Chapter 6D of the General Laws, as appearing in the 2018 Official Edition, 43is hereby amended by adding the following section: 44 Section 20. Patient-Centeredness Standards for Health Policy Commission Reviews 45 Section 20 (a) Standards for Patient-Centeredness in Research & Analysis. The Health 46Policy Commission shall ensure that any portfolio of research and analysis relied upon for 47determining the value of a healthcare treatment or service , whether provided by a state agency 48or a third party, impacting enrollee access to healthcare treatments and services, meets standards 49of patient-centeredness. The Health Policy Commission shall publicly provide a summary of 50patient-centeredness standards for any such analysis that includes, but is not limited to: 51 1) Evaluation of a range of research and analysis that includes outcomes prioritized by 52patients and people with disabilities within a specific disease area. If necessary, the Health Policy 53Commission will commission a survey of patients to identify relevant outcomes within a disease 54area. 4 of 4 55 2) Evaluation of a range of research and analysis that looks at relevant patient subgroups 56to ensure consideration of important differences in preferences and clinical characteristics within 57patient subpopulations. 58 3) Scientific Rigor: The Health Policy Commission shall require research and analysis to 59comply with good research practices, defined as consideration of the full range of relevant, peer- 60reviewed evidence (e.g., real-world evidence, research from range of sponsors including 61manufacturers), avoid patient harm through over-interpretation of findings of “inconclusive” 62evidence of clinical differences and instead allow time for conduct of additional research. 63 (b) Prohibition on Reliance on Discriminatory Measures. The Health Policy Commission 64shall not develop or utilize, directly or indirectly through a contracted entity or other third-party, 65a dollars-per-quality adjusted life year or any similar measures or research in determining 66whether a particular health care treatment is cost effective, recommended, the value of a 67treatment, or in determining coverage, reimbursement, appropriate payment amounts, cost- 68sharing, or incentive policies or programs.