Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S699 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. 1714 FILED ON: 1/16/2025
3	3	SENATE . . . . . . . . . . . . . . No. 699
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 relative to unilateral contract changes.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Brendan P. CrightonThird EssexErika Uyterhoeven27th Middlesex2/28/2025 1 of 3
16	16	SENATE DOCKET, NO. 1714 FILED ON: 1/16/2025
17	17	SENATE . . . . . . . . . . . . . . No. 699
18	18	By Mr. Crighton, a petition (accompanied by bill, Senate, No. 699) of Brendan P. Crighton and
19	19	Erika Uyterhoeven for legislation relative to unilateral contract changes with health care
20	20	providers. Financial Services.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Fourth General Court
24	24	(2025-2026)
25	25	_______________
26	26	An Act relative to unilateral contract changes.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Section 15 of chapter 176O of the General Laws is hereby amended by
30	30	2striking out subsection j and inserting in place thereof the following new subsection:-
31	31	3 (j) No carrier shall make a contract with a health care provider which includes a provision
32	32	4permitting termination without cause. A carrier shall provide a written statement to a provider of
33	33	5the reason or reasons for such provider's involuntary disenrollment. No carrier shall make a
34	34	6contract with a health care provider which includes a provision permitting the carrier to make a
35	35	7unilateral change to any material term or condition of such contract, including, but not limited to,
36	36	8changes to underlying fee schedules, payment terms, carrier policies or procedures, definitions of
37	37	9covered services or covered sites of services, policies associated with utilization review, quality
38	38	10management and improvement, credentialing or covered preventive health services, other than a
39	39	11change expressly required by law, unless the effective date of such unilateral change is after the
40	40	12end of the then-current term of such contract, and notice of such change was provided, in 2 of 3
41	41	13writing, to the health care provider more than 90 days before the date by which the health care
42	42	14provider must provide notice of termination or non-renewal to the carrier under such contract.
43	43	15Nothing herein shall prohibit a carrier and a health care provider from entering into a mutually-
44	44	16agreeable amendment to such contract.
45	45	17 SECTION 2. Section 4 of chapter 32A of the General Laws is hereby amended by
46	46	18inserting after the first paragraph the following new paragraph:-
47	47	19 The commission shall not purchase a policy providing health insurance benefits from an
48	48	20insurance company whose contract with a healthcare provider under said policy includes a
49	49	21provision permitting termination without cause. The commission shall not purchase a policy
50	50	22providing health insurance benefits from an insurance company whose contract with a healthcare
51	51	23provider under said policy includes a provision permitting the carrier to make a unilateral change
52	52	24to any material term or condition of such contract, including, but not limited to, changes to
53	53	25underlying fee schedules, payment terms, carrier policies or procedures, definitions of covered
54	54	26services or covered sites of services, policies associated with utilization review, quality
55	55	27management and improvement, credentialing or covered preventive health services, other than a
56	56	28change expressly required by law, unless the effective date of such unilateral change is after the
57	57	29end of the then-current term of such contract, and notice of such change was provided, in
58	58	30writing, to the health care provider more than 90 days before the date by which the health care
59	59	31provider must provide notice of termination or non-renewal to the carrier under such contract.
60	60	32Nothing herein shall prohibit an insurance company and a health care provider from entering into
61	61	33a mutually-agreeable amendment to such contract. 3 of 3
62	62	34 SECTION 3. Section 4A of chapter 32A of the General Laws is hereby amended by
63	63	35inserting at the end of the first paragraph the following:-
64	64	36 The commission shall not enter into such service-type contracts if said contract includes a
65	65	37provision permitting the termination without cause of a healthcare provider. The commission
66	66	38shall not enter into such service-type contracts if said contract includes a provision permitting the
67	67	39carrier to make a unilateral change to any material term or condition of such contract, including,
68	68	40but not limited to, changes to underlying fee schedules, payment terms, carrier policies or
69	69	41procedures, definitions of covered services or covered sites of services, policies associated with
70	70	42utilization review, quality management and improvement, credentialing or covered preventive
71	71	43health services, other than a change expressly required by law, unless the effective date of such
72	72	44unilateral change is after the end of the then-current term of such contract, and notice of such
73	73	45change was provided, in writing, to the health care provider more than 90 days before the date by
74	74	46which the health care provider must provide notice of termination or non-renewal to the carrier
75	75	47under such contract. Nothing herein shall prohibit an insurance company and a health care
76	76	48provider from entering into a mutually-agreeable amendment to such contract.