Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S902 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. 1569 FILED ON: 1/16/2025
3	3	SENATE . . . . . . . . . . . . . . No. 902
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Pavel M. Payano
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 lowering health care prices for patients.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Pavel M. PayanoFirst Essex 1 of 3
16	16	SENATE DOCKET, NO. 1569 FILED ON: 1/16/2025
17	17	SENATE . . . . . . . . . . . . . . No. 902
18	18	By Mr. Payano, a petition (accompanied by bill, Senate, No. 902) of Pavel M. Payano for
19	19	legislation to lower health care prices for patients by limiting the rate that can be charged for
20	20	services to not exceed 200 percent of the amount paid by Medicare for the service. Health Care
21	21	Financing.
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 lowering health care prices for patients.
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 Chapter 111 of the General Laws is hereby amended by inserting after section 51L the
31	31	2following section:-
32	32	3 Section 51M. (a) As used in this section, the following terms shall have the following
33	33	4meanings:-
34	34	5 “Health care provider”, a provider of medical or health services or any other person or
35	35	6organization that furnishes, bills or is paid for health care service delivery in the normal course
36	36	7of business.
37	37	8 “Hospital”, a hospital licensed pursuant to section 51 of chapter 111, the teaching
38	38	9hospital of the University of Massachusetts Medical School and any psychiatric facility licensed
39	39	10under section 19 of chapter 19. 2 of 3
40	40	11 “Provider organization”, any corporation, partnership, business trust, association or
41	41	12organized group of persons, which is in the business of health care delivery or management,
42	42	13whether incorporated or not that represents 1 or more health care providers in contracting with
43	43	14carriers for the payments of heath care services; provided, that ''provider organization'' shall
44	44	15include, but not be limited to, physician organizations, physician-hospital organizations,
45	45	16independent practice associations, provider networks, accountable care organizations, clinical
46	46	17laboratories, imaging facilities and any other organization that contracts with carriers for
47	47	18payment for health care services.
48	48	19 (b) A health care provider shall not charge, bill, or collect payment for health care
49	49	20services at a rate that exceeds 200 percent of the amount paid by Medicare for the service.
50	50	21 (c) A hospital shall not charge, bill, or collect payment for health care services at a rate
51	51	22that exceeds 200 percent of the amount paid by Medicare for the service.
52	52	23 (d) A provider organization shall not charge, bill, or collect payment for health care
53	53	24services at a rate that exceeds 200 percent of the amount paid by Medicare for the service.
54	54	25 (e) Every health care provider, hospital, and provider organization which provides
55	55	26covered services to a person must provide such services to any such person as a condition of
56	56	27their licensure, and must accept payment consistent with the provisions of this section, and may
57	57	28not balance bill such person for any amount in excess of the amount paid by the payor pursuant
58	58	29to this section, other than applicable co-payments, co-insurance, and deductibles.
59	59	30 (g) A health care provider, hospital, or provider organization shall not recoup or seek to
60	60	31recoup amounts in excess of the amounts charged to carriers pursuant to this section by
61	61	32increasing charges to other health benefit plans or other payers. 3 of 3
62	62	33 (f) The department may promulgate regulations to monitor and ensure compliance with
63	63	34this section. The attorney general shall have concurrent authority with the department to review
64	64	35and monitor compliance with this section.