Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S764 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. 1133 FILED ON: 1/15/2025
3	3	SENATE . . . . . . . . . . . . . . No. 764
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Adam Gomez
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 prompt access to health care.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Adam GomezHampden 1 of 4
16	16	SENATE DOCKET, NO. 1133 FILED ON: 1/15/2025
17	17	SENATE . . . . . . . . . . . . . . No. 764
18	18	By Mr. Gomez, a petition (accompanied by bill, Senate, No. 764) of Adam Gomez for legislation
19	19	to ensure prompt access to health care. Financial Services.
20	20	[SIMILAR MATTER FILED IN PREVIOUS SESSION
21	21	SEE SENATE, NO. 654 OF 2023-2024.]
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 ensuring prompt access to health care.
28	28	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
29	29	of the same, as follows:
30	30	1 SECTION 1. Chapter 32A of the General Laws, as appearing in the 2022 Official
31	31	2Edition, is hereby amended by adding at the end the following new section:-
32	32	3 Section 31: Reimbursement of costs for medically appropriate evaluation and
33	33	4management services in outpatient settings, including but not limited to office-based and
34	34	5hospital-based clinics, in accordance with guidelines developed by the division of insurance,
35	35	6shall be part of a basic benefits package offered by the insurer or a third party and shall not
36	36	7require a co-payment or deductible; provided, however, that co-payments and deductibles shall
37	37	8be required if the applicable plan is governed by the Federal Internal Revenue Code and would
38	38	9lose its tax-exempt status as a result of the prohibition on such for these services. 2 of 4
39	39	10 SECTION 2. Chapter 32B of the General Laws, as appearing in the 2022 Official
40	40	11Edition, is hereby amended by adding at the end the following new section:-
41	41	12 Section 30: Reimbursement of costs for medically appropriate evaluation and
42	42	13management services in outpatient settings, including but not limited to office-based and
43	43	14hospital-based clinics, in accordance with guidelines developed by the division of insurance,
44	44	15shall be part of a basic benefits package offered by the insurer or a third party and shall not
45	45	16require a co-payment or deductible; provided, however, that co-payments and deductibles shall
46	46	17be required if the applicable plan is governed by the Federal Internal Revenue Code and would
47	47	18lose its tax-exempt status as a result of the prohibition on such for these services.
48	48	19 SECTION 3. Chapter 175 of the General Laws, as appearing in the 2022 Official Edition,
49	49	20is hereby amended by inserting after Section 47KK the following section:-
50	50	21 Section 47QQ: Reimbursement of costs for medically appropriate evaluation and
51	51	22management services in outpatient settings, including but not limited to office-based and
52	52	23hospital-based clinics, in accordance with guidelines developed by the division of insurance,
53	53	24shall be part of a basic benefits package offered by the insurer or a third party and shall not
54	54	25require a co-payment or deductible; provided, however, that co-payments and deductibles shall
55	55	26be required if the applicable plan is governed by the Federal Internal Revenue Code and would
56	56	27lose its tax-exempt status as a result of the prohibition on such for these services.
57	57	28 SECTION 4. Chapter 176A of the General Laws, is hereby amended by inserting after
58	58	29Section 8MM the following section:-
59	59	30 Section 8RR: Reimbursement of costs for medically appropriate evaluation and
60	60	31management services in outpatient settings, including but not limited to office-based- and 3 of 4
61	61	32hospital-based clinics, in accordance with guidelines developed by the division of insurance,
62	62	33shall be part of a basic benefits package offered by the insurer or a third party and shall not
63	63	34require a co-payment or deductible; provided, however, that co-payments and deductibles shall
64	64	35be required if the applicable plan is governed by the Federal Internal Revenue Code and would
65	65	36lose its tax-exempt status as a result of the prohibition on such for these services.
66	66	37 SECTION 5. Chapter 176B of the General Laws, as appearing in the 2022 Official
67	67	38Edition, is hereby amended by inserting after Section 4MM the following section:-
68	68	39 Section 4RR: Reimbursement of costs for medically appropriate evaluation and
69	69	40management services in outpatient settings, including but not limited to office-based and
70	70	41hospital-based clinics, in accordance with guidelines developed by the division of insurance,
71	71	42shall be part of a basic benefits package offered by the insurer or a third party and shall not
72	72	43require a co-payment or deductible; provided, however, that a co-payment and deductible shall
73	73	44be required if the applicable plan is governed by the Federal Internal Revenue Code and would
74	74	45lose its tax-exempt status as a result of the prohibition on such for these services.
75	75	46 SECTION 6. Chapter 176G of the General Laws, as appearing in the 2022 Official
76	76	47Edition, is hereby amended by adding at the end the following new section:-
77	77	48 Section 34: Reimbursement of costs for medically appropriate evaluation and
78	78	49management services in outpatient settings, including but not limited to office-based and
79	79	50hospital-based clinics, in accordance with guidelines developed by the division of insurance,
80	80	51shall be part of a basic benefits package offered by the insurer or a third party and shall not
81	81	52require a co-payment or deductible; provided, however, that a co-payment and deductible shall 4 of 4
82	82	53be required if the applicable plan is governed by the Federal Internal Revenue Code and would
83	83	54lose its tax-exempt status as a result of the prohibition on such for these services.