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