Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S691 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 1071 FILED ON: 1/15/2025
3	3	SENATE . . . . . . . . . . . . . . No. 691
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Brendan P. Crighton
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 ensuring access to healthcare and medically necessary food for children.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Brendan P. CrightonThird Essex 1 of 3
16	16	SENATE DOCKET, NO. 1071 FILED ON: 1/15/2025
17	17	SENATE . . . . . . . . . . . . . . No. 691
18	18	By Mr. Crighton, a petition (accompanied by bill, Senate, No. 691) of Brendan P. Crighton for
19	19	legislation to ensure access to healthcare and medically necessary food for children. Financial
20	20	Services.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE SENATE, NO. 604 OF 2023-2024.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Fourth General Court
26	26	(2025-2026)
27	27	_______________
28	28	An Act ensuring access to healthcare and medically necessary food for children.
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. (a) Section 1 of chapter 176O of the General Laws, as appearing in the 2022
32	32	2Official Edition, is hereby amended by inserting after the definition of “covered benefits” the
33	33	3following definition:-
34	34	4 “covered disease or condition”, Immunoglobulin E and non-Immunoglobulin E-mediated
35	35	5allergies to food proteins, including the following: (i) food protein-induced enterocolitis
36	36	6syndrome. (ii) Immunoglobulin E and non-Immunoglobulin E-mediated allergies to food
37	37	7proteins; and (iii) Eosinophilic disorders, including eosinophilic esophagitis, eosinophilic
38	38	8gastroenteritis, eosinophilic colitis, and post-transplant eosinophilic disorders. 2 of 3
39	39	9 (b) Said Section 1 of said chapter 176O, as so appearing, is hereby amended by inserting
40	40	10after the definition of “medical necessity” or “medically necessary” the following definition:-
41	41	11 “Medically necessary food”, food, including a low protein modified food product, an
42	42	12amino acid preparation product, a modified fat preparation product, or a nutritional formula,
43	43	13including such a formula that does not require a prescription, that is: (i) furnished pursuant to the
44	44	14prescription, order, or recommendation, as applicable, of a physician or other health care
45	45	15professional qualified to make such prescription, order, or recommendation, for the dietary
46	46	16management of a covered disease or condition; (ii) a specially formulated and processed product
47	47	17(as opposed to a naturally occurring food stuff used in its natural state) for the partial or
48	48	18exclusive feeding of an individual by means of oral intake or enteral feeding by tube; (iii)
49	49	19intended for the dietary management of an individual who, because of therapeutic or chronic
50	50	20medical needs, has limited or impaired capacity to ingest, digest, absorb, or metabolize ordinary
51	51	21food stuffs or certain nutrients, or who has other special medically determined nutrient
52	52	22requirements, the dietary management of which cannot be achieved by the modification of the
53	53	23normal diet alone; (iv) intended to be used under medical supervision, which may include in a
54	54	24home setting; and (v) intended only for an individual receiving active and ongoing medical
55	55	25supervision wherein the individual requires medical care on a recurring basis for, among other
56	56	26things, instructions on the use of the food. Unless otherwise noted, the term “Medically
57	57	27necessary food” shall not include (i) foods taken as part of an overall diet designed to reduce the
58	58	28risk of a disease or medical condition or as weight loss products, even if they are recommended
59	59	29by a physician or other health professional; (ii) foods marketed as gluten-free for the
60	60	30management of celiac disease or non-celiac gluten sensitivity; and (iii) foods marketed for the
61	61	31management of diabetes. 3 of 3
62	62	32 SECTION 2. Section 15 of said chapter 176O of the General Laws, as so appearing, is
63	63	33hereby amended by inserting the following:-
64	64	34 (l) No carrier shall require an insured to obtain a referral or prior authorization from a
65	65	35primary care provider for specialty care provided by an immunologist or family practitioner
66	66	36participating in such carrier's health care provider network; no carrier shall categorize
67	67	37prescription coverage as “durable medical equipment”; no carrier shall apply prescription co-pay
68	68	38and deductible for medically necessary food.