Senate Healthcare Bill Overview

On Thursday, the Senate passed the HEALTH Act (S.2202) by a vote of 33-6. The bill focuses on both short and long term goals to lower costs, improve outcomes, and expand access to care.

Key elements of the legislation include:

  • More effective care delivery, including increased access to telemedicine and mobile integrated health services.
  • Strategies for reducing avoidable hospital readmissions and unnecessary emergency department use, including measures to improve access to behavioral health services.
    • The Massachusetts Health Policy Commission has estimated that 42% of all emergency department visits are avoidable.
  • Greater provider versatility, including expanded scope of practice for many practitioners including dental therapists, optometrists, podiatrists, and advanced practice nurses.
  • Addressing price variation between larger hospitals and smaller community hospitals by implementing a floor for providers while also setting a benchmark for hospital spending.
  • Increased transition planning for patients into community settings and strengthening of coordination among providers.
    • Post-acute care in an institutional setting and long term care and supports (LTSS) cost the state an estimated $4.7 billion in 2015, a major cost driver for MassHealth.
  • Greater oversight and transparency in drug costs. Opportunity for lower costs through bulk purchasing arrangements, including a multistate drug purchasing consortium.
    • Pharmaceutical costs have been a driver of increased healthcare costs for a number of years. The Center for Health Information and Analysis (CHIA) reported a 6.4% growth in pharmaceutical spending in 2016.
  • Increased health care price transparency for consumers.
  • Better leveraging of federal funding opportunities.

I offered a number of successful amendments that further strengthen the bill’s provisions around behavioral health, long-term care and consumer protections:

  • Amendment 16 to establish a commission to determine appropriate training and certification requirements for mental health peer specialists.
  • Amendments 18 and 48 to collect and report data on the true cost of providing outpatient and diversionary behavioral health services. This is an important first step toward making the case for establishing rate floors to more adequately reimburse for these services.
  • Amendment 69 to strengthen the licensing requirements for new nursing home owners.
  • Amendment 77 to create a study commission to develop standards and requirements for insurance companies to provide more accurate and up-to-date information about the health care providers in their networks. This will be a particular improvement for those seeking behavioral health services, who often find it takes weeks or months to find a clinician who accepts their insurance.
  • Amendment 83 to create a behavioral health urgent care working group to examine and make recommendations on the current availability and location of urgent behavioral health care services; the barriers to developing or providing urgent behavioral health care services, including rates of reimbursement for such services; the adequacy of existing regulatory structures to facilitate the development and provision of urgent behavioral health care services; issues related to compliance with state and federal parity laws; and criteria for licensure of behavioral health urgent care facilities.

I also co-sponsored several successful amendments, including one to initiate a study of a single-payer option for Massachusetts (Amendment 2) and an amendment restricting retroactive denials of insurance for mental health and addiction services (Amendment 143).The bill now heads to the House of Representatives for consideration.

Should you have any questions about the HEALTH Act, please feel free to reach out to my office by phone at (617) 722-1432 or by email at