Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S793 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. 989 FILED ON: 1/15/2025
3	3	SENATE . . . . . . . . . . . . . . No. 793
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Mark C. Montigny
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 save lives by preventing unscrupulous medical referral restrictions by profit-driven
13	13	health care networks.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :Mark C. MontignySecond Bristol and Plymouth 1 of 2
17	17	SENATE DOCKET, NO. 989 FILED ON: 1/15/2025
18	18	SENATE . . . . . . . . . . . . . . No. 793
19	19	By Mr. Montigny, a petition (accompanied by bill, Senate, No. 793) of Mark C. Montigny for
20	20	legislation to save lives by preventing unscrupulous medical referral restrictions by profit-driven
21	21	health care networks. Financial Services.
22	22	[SIMILAR MATTER FILED IN PREVIOUS SESSION
23	23	SEE SENATE, NO. 683 OF 2023-2024.]
24	24	The Commonwealth of Massachusetts
25	25	_______________
26	26	In the One Hundred and Ninety-Fourth General Court
27	27	(2025-2026)
28	28	_______________
29	29	An Act to save lives by preventing unscrupulous medical referral restrictions by profit-driven
30	30	health care networks.
31	31	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
32	32	of the same, as follows:
33	33	1 SECTION 1. Section 11 of chapter 6D of the General Laws, as so appearing in the 2022
34	34	2Official Edition, is hereby amended by inserting after subsection (e) the following subsection:-
35	35	3 (f) The commission may suspend, revoke, or refuse to renew a provider organization’s
36	36	4registration upon a violation of section 187 of chapter 149 or subsection (a) of section 16 of
37	37	5chapter 176O.
38	38	6 SECTION 2. Subsection (b) of section 187 of chapter 149 of the General Laws, as so
39	39	7appearing, is hereby amended by inserting after clause (4) the following clause:- 2 of 2
40	40	8 (5) refers a patient to an outside, non-affiliated health care facility or provider if: (i) the
41	41	9outside, non-affiliated health care facility or provider is that other than the health care provider’s
42	42	10facility or place of employment and (ii) the health care provider reasonably believes said referral
43	43	11is in the best interest of the patient or at the direct request of the patient.
44	44	12 SECTION 3. Section 16 of chapter 176O of the General Laws, as so appearing, is hereby
45	45	13amended by striking the last sentence in subsection (a) and inserting in place thereof the
46	46	14following:-
47	47	15 Nothing in this section shall be construed as altering, affecting or modifying either the
48	48	16obligations of any third party or the terms and conditions of any agreement or contract between
49	49	17either the treating physician or the insured and any third party, except for any obligation,
50	50	18agreement or contract between a physician and a third party that unduly restricts an insured from
51	51	19receiving medically necessary services ordered by a treating physician, primary care provider, or
52	52	20other health care professional. No facility, health care provider, or licensed health care provider
53	53	21group shall unduly restrict medically necessary health care services or referrals for said services
54	54	22provided to an insured by a treating physician, primary care provider, or other health care
55	55	23professional based solely upon a facility, provider, or provider group’s network or affiliation
56	56	24status with another facility, provider or provider group. Any attempt by a facility, health care
57	57	25provider, or licensed health care provider group to prohibit or hinder said services or referrals
58	58	26shall constitute an unfair method of competition and unfair or deceptive act in violation of
59	59	27chapter 93A.