Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S692 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. 1141 FILED ON: 1/15/2025
3	3	SENATE . . . . . . . . . . . . . . No. 692
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 to facilitate timely access to quality health care by expanding access to patient
13	13	navigation.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :Brendan P. CrightonThird EssexJames B. EldridgeMiddlesex and Worcester2/28/2025Bruce E. TarrFirst Essex and Middlesex2/28/2025 1 of 3
17	17	SENATE DOCKET, NO. 1141 FILED ON: 1/15/2025
18	18	SENATE . . . . . . . . . . . . . . No. 692
19	19	By Mr. Crighton, a petition (accompanied by bill, Senate, No. 692) of Brendan P. Crighton,
20	20	James B. Eldridge and Bruce E. Tarr for legislation to facilitate timely access to quality health
21	21	care by expanding access to patient navigation. Financial Services.
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Fourth General Court
25	25	(2025-2026)
26	26	_______________
27	27	An Act to facilitate timely access to quality health care by expanding access to patient
28	28	navigation.
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 Chapter 118E of the General Laws is hereby amended by inserting after section 10Q, the
32	32	2following section:-
33	33	3 Section 10R. (a) As used in this section, the following words shall have the following
34	34	4meanings:
35	35	5 “Community health worker” means a frontline health worker who serves as a liaison
36	36	6between patients, health-care providers, social service providers and community members to
37	37	7facilitate access to health-related services in the community the health worker serves, including
38	38	8access to physical, behavioral, and preventive health services or access to services to address
39	39	9social determinants of health.
40	40	10 “Patient navigation services” means the following services furnished by a community
41	41	11health worker to patients in their communities: 2 of 3
42	42	12 1. Services to prevent or screen for chronic diseases (such as cancer) and services
43	43	13designed to slow the progression of chronic diseases.
44	44	14 2. Screenings for nonclinical and social needs and referrals to appropriate services and
45	45	15agencies to meet those needs.
46	46	16 3. Group and individual education to prevent illness or disease, including the promotion
47	47	17of healthy behaviors to increase awareness and prevent the development of illness or disease.
48	48	18 4. Health coaching, health navigation, health advocacy, and individual supports,
49	49	19including transitions of care supports.
50	50	20 5. Overcoming cultural factors, such as language, socioeconomic status, or health
51	51	21literacy, to properly understand treatment options or treatment plans.
52	52	22 6. Diagnosis-related patient education with respect to treatment and self-management of a
53	53	23health condition or illness, including helping patients learn to effectively comply with medical
54	54	24care instructions.
55	55	25 7. Any other service approved by the division.
56	56	26 (b) The division and its contracted health insurers, health plans, health maintenance
57	57	27organizations, behavioral health management firms and third-party administrators under contract
58	58	28to a Medicaid managed care organization or primary care clinician plan shall provide coverage
59	59	29for patient navigation service as defined in this section to improve access to care for individuals
60	60	30who are eligible for screening, follow-up or treatment services. 3 of 3
61	61	31 (c) Reimbursement shall be provided to individuals who are trained and have completed a
62	62	32national patient navigation certification or credentialing program, or other certification or
63	63	33training program approved by the executive office of health and human services.
64	64	34 (d) The executive office of health and human services shall obtain any federal
65	65	35authorization necessary to implement this section and maximize federal financial participation
66	66	36for the coverage and benefits provided under this section.
67	67	37 (e) The office of Medicaid shall promulgate regulations or other guidance necessary to
68	68	38effectuate this section.
69	69	39 (f) This act shall apply to all contracts entered into, renewed or amended on or after
70	70	40January 1, 2026.