2023-2024 Legislation

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Bill Summary: This bill would address disparities between the rate of pay for human services workers employed directly by the state and those employed by agencies with which the state contracts. The bill would require the state, over the course of four years, to increase its rate of reimbursement for human services providers in order to reduce and ultimately eliminate the pay disparity. An annual report will be published until the disparity amount is eliminated that details the current disparity amount, the amount of annual increases in the rate of reimbursement needed to achieve the reduction and elimination in disparity amounts, and the amount needed to be appropriated annually to achieve the reduction and elimination of disparity amounts. 

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Bill Summary: This bill would direct the Massachusetts Department of Environmental Protection (DEP), in consultation with the Toxics Use Reduction Institute, to create and publish: (1) a list of toxic chemicals of concern in children’s products; (2) a list of high priority chemicals in children’s products; and (3) a list of safer alternative chemicals that can replace chemicals on the high priority chemical list. Manufacturers who make children’s consumer products that are for sale in the Commonwealth would be required to report detailed information to DEP about the inclusion of toxic chemicals of concern in their products, information that would be made public on DEP’s website.  The DEP would be required every 3 years to report and make recommendations on additional ways to reduce exposure to toxic chemicals in children’s products. The bill would also ban PFAS in children’s products, subject to rules and regulations promulgated by the department. 

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Bill Summary: This bill would remove barriers to political contributions by low-wage workers through a system of universal voluntary payroll deduction. The bill would enable employees, even if they do not have a bank account, to make regular small voluntary contributions via payroll deduction to 501(c)(4) not-for-profit organizations and PACs.  

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Bill Summary: This bill would establish the rates of payment for out-of-network care delivered: (1) in an emergency; (2) without the patient’s knowledge; (3) without notice to the patient that the provider was out-of-network; or (4) when an in-network provider is not available. It would task the Division of Insurance (DOI), in consultation with the Center for Health Information and Analysis (CHIA), the Health Policy Commission (HPC) and the Executive Office of Health and Human Services (EOHHS) with establishing a noncontracted commercial rate for emergency services and a noncontracted commercial rate for nonemergency services to be paid to a provider by an insurer when the provider is not part of the insurer’s network. Before establishing the rates for out-of-network care, DOI would be required to hold a public hearing. The rates established by DOI would be in effect for 5 years, and in year 4, DOI would initiate a new review and public hearing in order to set rates for the next 5-year term. 

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Bill Summary: This bill would require that insurance coverage for all medical care related to pregnancy, including c-section, be provided free of any deductibles, co-insurance, co-pays or other cost-sharing. The bill would also ensure that the appropriate oversight agency ensures health plan compliance with these provisions. 

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Bill Summary: The Affordable Care Act (ACA) requires nearly all private health plans to cover many critical preventive services without cost sharing. In September 2022, a federal judge in Texas ruled that much of the ACA’s preventive services requirement is unconstitutional. In the event that the U.S. Supreme Court hears the case and strikes down all, or even part, of the mandate to cover preventive services without cost, this bill will ensure that these services are still covered in Massachusetts. 

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Bill Summary: The bill would require the Executive Office of Health and Human Services, subject to appropriation, to increase the budget for continuous skilled nursing care in a stepwise fashion over 2023, 2024, and 2025 with the goal of achieving fulfillment of at least 85% of continuous skilled nursing hours authorized by MassHealth by 2025. It would also require MassHealth to submit an annual report detailing the number of filled and unfilled hours authorized by MassHealth, the number of reductions in hours, and the number of appeals of reductions or modifications of hours of continuous skilled nursing care. The report would also demonstrate that MassHealth had not, in the preceding year, changed its authorization requirements for skilled nursing hours. 

Finally, the bill would direct the Office of Medicaid to review the wage payment rates established by home health agencies that provide continuous skilled nursing care, conduct an analysis and make recommendations on criteria to be included in any future reporting by these home health agencies.  

This bill was moved to the Senate floor on Nov. 8, 2023 as PACT Act 3.0, and debated in the Senate on Nov. 15, 2023. To follow the current status of this legislation, please click the link below.

PACT Act 3.0 Bill Page

Introduced Bill Text

Introduced Bill Summary: This legislation takes a comprehensive approach to pharmaceutical cost control that focuses on access and cost improvement, transparency and oversight.  

The bill would add drug costs to the scope of health care cost analysis conducted by the Center for Health Information and Analysis (CHIA). This information would provide policymakers and consumers with an objective data source to understand drug cost drivers and to assess the impact of cost control initiatives. Similarly, pharmaceutical manufacturing companies and PBMs would be included in the Health Policy Commission (HPC) annual Health Care Cost Trends hearing process and would testify publicly on the factors that influence drug costs and provide supporting documents. The HPC, in turn, would use this information to develop an analysis on how pharmaceutical costs impact the state’s health care market and its residents. 

The bill would create a licensing process for PBMs and would require pharmaceutical companies to notify the state in advance of new drugs and biosimilars coming to market and of significant price increases for existing drugs. 

The bill would impose a number of provisions designed to reduce the burden of high prescription drug costs on consumers. First, it would direct the Health Policy Commission (HPC), in consultation with stakeholders, to establish a process for identifying drug price changes that pose a public health threat to our residents and the state, and it would allow HPC and manufacturers to enter into access improvement plans to help mitigate those costs; HPC would also be able to recommend pricing measures the state could employ to increase patient access to much-needed medications. Second, the bill would establish a prescription drug cost assistance program funded by a penalty on excessive drug prices. This program would eliminate out-of-pocket prescription drug expenses, for those meeting income guidelines, for certain essential drugs. Third, this bill would limit out-of-pocket insulin spending, for any resident with diabetes, by eliminating deductibles and coinsurance and capping co-pays at $25 per month. Lastly, the bill would establish a program under the Executive Office of Health and Human Services to cap out-of-pocket costs for certain high-value medications and CHIA, in turn, would evaluate the program and its impact on capping out-of-pocket costs for certain high-value medications every 2 years. All commercial carriers, the GIC, and MassHealth would be required to eliminate or cap cost-sharing for certain drugs under EOHHS’s program. 

The bill would also build upon recent federal action by requiring pharmacists to alert consumers if the retail cost of a medication is less than their cost-sharing amount (the co-pay, deductible or other amount required through their insurance plan). 

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Bill Summary: This bill takes several different approaches to increase investment in primary care, including: 

• Requiring the Health Policy Commission (HPC) and the Center for Health Information and Analysis (CHIA) to set a primary care expenditure target goal for the Commonwealth and individual entities so that by 2029 not less than 12% and not more than 15% of total health care expenditures is spent on primary care; 

• Establishing a new primary care board under HPC to develop a primary care prospective payment model that will allow providers to receive a lump sum monthly payment for all primary care services delivered, adjusted by a provider’s adoption of primary care transformers established by the board, the quality of patient care delivered by a provider, and the clinical and social risk of a provider’s patient panel; and 

• Establishing a trust fund to support the new prospective payment model developed by primary care board that will be paid into by (i) an assessment on carriers, providers, provider organization, and for-profit non-traditional health corporations and entities that provide, as part of a larger business model, primary care services in the Commonwealth, including retailers, pharmacy benefits manager, and private equity firms, (ii) revenue from appropriations or other money authorized by the general court, and (iii) interest earned on such revenues. 

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Bill Summary: This bill would create a new Chapter 151G of the General Laws to establish protections from sexual harassment and discrimination by professional investors. Under the bill, an individual may sue a professional investor for unlawful sexual harassment. The attorney general has the sole authority to sue a professional investor for discrimination under the new chapter. The bill would, however, allow professional investors to establish an affirmative defense to a discrimination lawsuit by completing the requirements set forth by the Massachusetts Commission Against Discrimination (MCAD). 

Bill Text

Bill Summary: This bill would mandate automatic sealing of criminal records by the Commissioner of Probation within 90 days of adults and juveniles becoming eligible for sealing after the applicable waiting period is completed. It would also require automatic sealing of criminal records of adults and juveniles found not guilty without the defendant having to file a petition or other request. If for any reason an individual or their legal representative needs access to the sealed records, this bill will allow them to access the records without first obtaining a court order or having to unseal the records. 

Bill Text

Bill Summary: This bill would create a new process to involuntarily commit an adult individual with a mental illness to community-based health, behavioral health, and social services. Criteria for eligibility would include a history of lack of compliance with treatment for mental illness and a finding that the individual is at substantial risk of inflicting serious harm to himself or others and has shown an inability to provide for basic physical needs, including medical and psychiatric treatment and shelter. 

The commitment process would begin when one of the following files a petition with the courts: a physician licensed in Massachusetts, the Department of Mental Health, the spouse, blood relative, legal relative, legal guardian or individual partner in a substantive dating relationship, the superintendent of a medical facility or residence where the individual receives medical care, or the medical director of Bridgewater State Hospital. The petition would need to include a written community health service treatment plan, and could be filed alongside a petition for involuntary inpatient commitment. 

A required hearing would begin within four days of filing the petition. The court would only be able to mandate critical community health services if it finds that the individual meets the eligibility criteria and finds that these services are the least restrictive alternative available. The court would then approve a treatment plan and order a mental health professional to supervise the plan. The supervising mental health professional would routinely review the patient’s condition and submit reports to the courts regarding their progress, and could petition the court for a hearing if the individual is not complying with the treatment plan. If the court finds that an individual is not complying, the court could amend the treatment plan or request an evaluation to determine if the patient meets the criteria for involuntary inpatient commitment.  

All hearings would be conducted by a judge. The patient would be entitled to counsel, and the court, if necessary, would appoint counsel. The evidentiary standard for all hearings would be clear and convincing evidence. 

The court would determine whether the individual, the petitioner, or the state would pay for reasonable expenses incurred by providing critical community health services. 

Bill Text

Bill Summary: This bill would allow for a defendant to motion for psychiatric observation or evaluation in order to aid the court in sentencing. It would also create a new finding of guilty but with a mental illness that would carry the same sentence as provided by law for a defendant found guilty of the same crime; provided however, if the sentence includes a term of imprisonment, the defendant would serve the sentence at a mental health facility, or if the defendant is a male and the court determines that strict security is required, at Bridgewater State Hospital. Consistent with public safety and security, the defendant would be required to be held in the least restrictive setting that is clinically indicated and would not create a likelihood of serious harm. 

Bill Text

Bill Summary: This bill would allow the court, when a defendant has an alcohol or substance use disorder, to order the defendant to participate in treatment as a condition of probation, but prohibit the court from imposing incarceration if a positive drug or alcohol test is the only infraction and the defendant is otherwise participating in treatment. 

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Bill Summary: This bill would decriminalize selling sex, including common nightwalking and streetwalking, and expunge the criminal records of trafficking and sex trade survivors for all previous prostitution charges. The bill expands access to critical community resources for those who want out of the sex trade, while maintaining current anti-trafficking laws. This bill would also establish a special commission, co-chaired by the Secretary of Health and Human Services and the Director of the Massachusetts Office for Victim Assistance, to review and develop a set of recommendations to prevent, identify and respond to all forms of prostitution in the Commonwealth.  

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Bill Summary: This bill would fix a loophole in current unemployment insurance (UI) law. Currently, workers that have been employed for the same length of time and earned exactly the same amount of wages may have unequal access to UI benefits depending on how those wages were distributed between 2 calendar quarters of the year preceding their claim for benefits. This problem arises for workers whose average weekly wage and weekly benefit amount are calculated on the basis of wages paid in their high quarter. Deserving workers who earn different amounts of income in 2 quarters due to mandatory overtime, business slow-downs, or other work schedules over which they often have no control, or who earn money in 1 quarter but are not paid those wages until the next quarter, are denied UI eligibility unfairly. 

Bill Text

Bill Summary: The bill would void any contract that waives a substantive right or remedy or procedural right, remedy, standard or practice relating to a claim of discrimination, retaliation or harassment, non-payment of wages or benefits, or violation of public policy in employment. Whoever requests an employee to agree to or enforces or attempts to enforce such waiver would be liable for damages, reasonable attorneys’ fees, and costs. The bill would also prohibit any person, employer or prospective employer from retaliating against a person who declines to enter into an agreement or contract that contains such a waiver and provides such person with a civil cause of action. Finally, where a contract is presented to an employee with the purpose of requiring the employee to bring to arbitration any matter relating to employment discrimination, retaliation or harassment, or nonpayment of wages or benefits that may later arise in the future, the bill would allow the employee to void the agreement after the dispute has arisen. The Attorney General (AGO) and the Massachusetts Commission Against Discrimination (MCAD) are authorized to enforce this bill. 

Bill Text

Bill Summary: This bill would help protect and improve access to inpatient psychiatric care in Massachusetts by addressing a number of areas. Currently, Massachusetts is an outlier in comparison to other states and national standards for requiring 24 hour physician coverage that is nearly impossible for freestanding hospitals to meet due to available physicians, is extremely costly, and not necessary to protect patient health and safety. This bill would require DMH regulations to take into consideration physician supply issues for inpatient mental health facilities.  

Additionally, there can be delays for weeks when seeking a second medical opinion and, in the meantime, the patient remains on the unit without treatment, even if the hospital believes such treatment is crucial for the patient. To address such delays, this bill would require the patient to request a second medical opinion within 24 hours of appointment of their attorney. It would also require the second opinion to be completed within 3 business days. Note, this bill would not take away the patient’s right to get a second opinion, but it would simply require that it be conducted more promptly. 

The bill would also address a delay in the commitment process. Currently, it can take weeks for a commitment hearing to come before the court – delaying treatment for the patient. This bill would ensure that the commitment hearings begin promptly after the filing of the petition. It would also remove a provision in M.G.L. c. 123 § 8B that allows for a patient or their attorney to request a delay of up to 14 days for a hearing. This would not remove the court’s ability to schedule the hearing, but rather, it would prevent delays to much needed treatment without compromising the patient’s ability to have the hearing. 

Finally, the bill would direct the Department of Children and Families (DCF) and the Child Advocate’s Office to create an expedited process for children under DCF care who are hospitalized in inpatient psychiatric hospitals and in need of anti-psychotic medication. 

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Bill Summary: This bill would require that people with substance use disorder (SUD) be treated as patients rather than as criminals. The bill would require that all Section 35 commitment beds for alcohol and SUD, for men as well as women, be in treatment facilities approved by the Department of Public Health (DPH) or the Department of Mental Health (DMH), and not in jails or correctional facilities. The bill also tasks the Secretary of the Executive Office of Health and Human Services with ensuring that there is an adequate supply of beds for the treatment of alcohol or SUD approved by the DPH or the DMH. The bill allows an exception for individuals concurrently committed pursuant to an order issued in a criminal case, as long as such correctional facility is capable of providing appropriate, evidence-based treatment. Individuals committed under this section would be encouraged to consent to further treatment upon release from a treatment facility.  

Bill Text

Bill Summary: This bill would require a shift in health care spending to achieve a significant increase in investment in behavioral health care services. The initial investment target would be 30% higher than the baseline behavioral health care spending, as calculated by the Center for Health Information and Analysis (CHIA)and would be in effect for 3 years. Thereafter, subsequent 3-year targets would be set by the Health Policy Commission (HPC) based on input and calculations from CHIA and after holding a public hearing. The system-wide health care cost growth benchmark would still apply as an upper limit on total health care spending. 

Health care systems and insurers would be held accountable for achieving the behavioral health investment target through the same process currently in effect for the health care cost growth benchmark – i.e. through the HPC cost growth hearing process and the performance improvement plan process.  

Bill Text

Bill Summary: This bill takes a number of approaches to reduce the administrative burdens that many healthcare providers face, including: 

• Requiring student health plans and the Group Insurance Commission (GIC) to adopt standardized utilization review criteria and prior authorization requirements, to apply those requirements consistently and to publish those requirements on their website; 
• Requiring carriers to report annually to Division of Insurance (DOI) detailed prior authorization approval and denial information on all admission, items, services, treatments, procedures, and medications; 

• Prohibiting a carrier from denying payment for a claim for medically necessary covered services on the basis of an administrative or technical defect in the claim unless the claim rendered was submitted fraudulently; 
• Standardizing the electronic prior authorization process; 
• Ensuring that patient who is stable on a treatment, service or course of medication as determined by a health care provider and approved for coverage by a previous carrier or health benefit plan, shall not be restricted from coverage of such treatment, service, or course of medication for at least 90 days if the patient switches health plans or carriers; 
• Requiring prior authorization approval for a prescribed treatment, service, or course of medication to be valid for the duration of a prescribed or ordered course of treatment, or at least 1 year; 
• Directing the Health Policy Commission to conduct an analysis of and issue a report on the use of utilization management tools, including prior authorization, and the effect on patient access to care, administrative burden on health care providers, and system cost; and 

• Requiring the Division of Insurance to develop and implement rules, regulations, bulletins or other guidance that prohibit carriers from imposing prior authorization requirements for any generic medication or on all admissions, items, services, treatments, procedures, and medications that have: (1) low variation in utilization across health care providers; (2) low denial rates across carriers; and (3) an evidence-base for the treatment or management of certain chronic diseases. 

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Bill Summary: Currently, MassHealth covers postpartum depression screenings for new mothers for up to 6 months after a child’s birth. This bill extends MassHealth coverage for screenings to 1 year after a child’s birth and expands coverage to all “parents”. 

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Bill Summary: This bill would require that the autopsy report for a child under the age of two be reviewed and approved by the Chief Medical Examiner to determine the cause of death. Changes to the autopsy report would also have to be reviewed and approved by the Chief Medical Examiner.

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Bill Summary: This bill tasks the Secretary of Health and Human Services, in consultation with various stakeholders in the health care system, with conducting an analysis and issuing a report on the health care workforce challenges facing the Commonwealth’s health care system, including the effects of health care job vacancies on the accessibility, quality, equitable delivery and cost of health care services. 

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Bill Summary: Upon the death of an active employee outside of work, their spouse may be entitled to an Option (d) survivor pension, which is similar to survivor benefits afforded under Social Security. Currently, the maximum Option (d) pension for a state employee or state employee survivor is $500 dollars a month. This bill would increase the Option (d) maximum pension from $500 to $750 monthly, or from $6,000 to $9,000 annually. 

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Bill Summary: Currently, pursuant to M.G.L. c. 32, § 12, members may choose Option D, Member Survivor Allowance. Option D states a member may nominate an eligible beneficiary (as set forth under Option C) who, if such member dies before being retired, shall receive the yearly amount of the Option C allowance to which such member would have been entitled had his or her retirement taken place on the date of his or her death. The Public Employee Retirement Administration Commission (PERAC) has determined that only 1 beneficiary can receive benefits under this provision. However, many active duty public safety personnel have multiple beneficiaries they would like to be able to leave a pension to (i.e., more than one child) in the event of an untimely death. This bill would change M.G.L. c. 32, § 12 to allow members of the retirement system to choose more than 1 beneficiary. Additionally, this bill would allow, if there is more than one beneficiary, and upon the death of a beneficiary, for the deceased beneficiary’s portion to be divided evenly among surviving beneficiaries.  

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Bill Summary: Under current law, a first responder forced to retire due to a “violent act injury” can only receive benefits through the local retirement board via the home rule legislative process. This process is onerous and has resulted in disparate benefits being granted on a case-by-case basis.  

This bill would allow a small subset of severely injured Group 4 public safety officers that retire due to accidental disability because they were the victims of a violent act injury to be eligible to receive 100 percent of their regular compensation, including applicable benefits and stipends until they reach the age of mandatory retirement. At that time, they would be eligible for 80 percent of the pension including cost of living (COLA) increases.  

The bill would also provide the member’s pension benefits to the member’s spouse or children should the member predecease them.  

• The spousal pension rate would be 75 percent of the member’s pension, including COLA increases.  

• Children would divide the pension allowance evenly until reaching either age 18 or age 22 if they are enrolled in college, or indefinitely if they are permanently physically and mentally incapacitated.  

This bill would provide indemnification for hospital, medical and healthcare bills by the local retirement board for any costs not covered by health insurance and which were sustained due to the violent act injury. It would also allow members to receive supplemental employment outside of jobs in Groups 1-4 in the retirement system.  

Finally, this bill would not prohibit additional benefits not required in statute from being granted by local retirement boards.  

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Bill Summary: This bill would extend the time period of the deferred property tax rate to one year after the death of the property owner receiving the deferment in order to allow for probate and the settling of any will. This would give heirs time to either sell the property or pay the taxes before the interest rate rises back up to 16% on deferred taxes. This change would only be applicable to active duty military personnel and the elderly who have received a deferment.   

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Bill Summary: This legislation would allow municipalities to fund local or regional transportation projects through ballot initiative.  

Under the bill, municipalities would gain the ability to implement tax surcharges on sales, real or personal property, room occupancy, vehicle excise, local vehicle excise, local transportation network company surcharge, local commercial parking surcharge, or any other tax then authorized to be assessed or collected by the Commonwealth or any city or town. For regional transportation projects, municipalities may vote to join a district with other municipalities. 

This legislation also would require municipalities accepting this chapter to establish a transportation committee to study the transportation-related needs, possibilities, and resources of the municipality, and deliver recommendations at least every other fiscal year. All revenue from the tax surcharge must be placed in a separate local and regional transportation fund, and in the case of a district, one municipality will be selected to establish the fund. 

The bill would create the Massachusetts Local and Regional Transportation Trust Fund, which would consist of revenues the state receives from the tax surcharge implemented, public and private sources, or other monies designated for the fund. 

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Bill Summary: This bill would designate the “Giant Puffball” fungus, calvatia gigantea, the official mushroom of the Commonwealth. 

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Bill Summary: This bill would mandate that a distribution or telephone company that has installed a double pole must complete the necessary wire transfers and pole removal within 90 days from the date of installation, or pay a $200 daily fine (after 90 days) to the municipality where the pole is located.  

For any commercial or industrial construction project expected to take longer than one year to complete, the distribution and telephone companies would have six months to remove the double pole before paying the daily $200 fine to the municipality where the pole is located.