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SENATE DOCKET, NO. 822 FILED ON: 1/14/2025
SENATE . . . . . . . . . . . . . . No. 818
The Commonwealth of Massachusetts
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PRESENTED BY:
Pavel M. Payano
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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 relative to eliminating the PCP referral requirement for specialty gynecological care.
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PETITION OF:
NAME:DISTRICT/ADDRESS :Pavel M. PayanoFirst Essex 1 of 1
SENATE DOCKET, NO. 822 FILED ON: 1/14/2025
SENATE . . . . . . . . . . . . . . No. 818
By Mr. Payano, a petition (accompanied by bill, Senate, No. 818) of Pavel M. Payano for
legislation to eliminate the PCP referral requirement for specialty gynecological care. Financial
Services.
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 relative to eliminating the PCP referral requirement for specialty gynecological care.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 Subsection (g) of section 15 of chapter 176O of the General Laws, as appearing in the
22022 Official Edition, is hereby amended by striking out the first sentence and inserting in place
3thereof the following sentence:- No carrier shall require an insured to obtain a referral or prior
4authorization from a primary care provider for specialty care provided by an obstetrician,
5gynecologist, certified nurse-midwife or family practitioner participating in such carrier's health
6care provider network for the following: (i) annual preventive gynecologic health examinations,
7including any subsequent obstetric or gynecological services determined by such obstetrician,
8gynecologist, certified nurse-midwife or family practitioner to be medically necessary as a result
9of such examination; (ii) preventative gynecologic health care and menstrual health conditions
10such as abnormal uterine bleeding, dysmenorrhea and pelvic pain; (iii) maternity care; and (iv)
11medically necessary evaluations and resultant health care services for acute or emergency
12gynecological conditions.