By Representative Sabadosa of Northampton, a petition (accompanied by bill, House, No. 1309) of Lindsay N. Sabadosa relative to reimbursements of costs for medically appropriate evaluations and management services in outpatient settings. Financial Services.
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Date
Branch
Action
8/28/2025
Joint
8/28/2025 JointHearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual — Hearing updated to New End Time
7/31/2025
House
7/31/2025 HouseAccompanied a new draft, see H4342↗
4/23/2025
Joint
4/23/2025 JointHearing scheduled for 04/29/2025 from 10:00 AM-02:00 PM in A-2
2/27/2025
Senate
2/27/2025 SenateSenate concurred
2/27/2025
House
2/27/2025 HouseReferred to the committee on Financial Services
Chapter 32A of the General Laws is hereby amended by adding at the end the following new section:
▸SECTION 28
: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
▸SECTION 2
Chapter 32B of the General Laws is hereby amended by adding at the end the following new section:
▸SECTION 30
: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
▸SECTION 3
Chapter 175 of the General Laws is hereby amended by inserting the following section:-
▸SECTION 47L
L: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
▸SECTION 4
Chapter 176A of the General Laws is hereby amended by inserting the following section:-
▸SECTION 8N
N: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
▸SECTION 5
Chapter 176B of the General Laws is hereby amended by inserting the following section:-
▸SECTION 4N
N: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that a deductible shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
▸SECTION 6
Chapter 176G of the General Laws is hereby amended by inserting the following new section 33:-
▸SECTION 33
: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that a deductible shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
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SECTION 1. Chapter 32A of the General Laws is hereby amended by adding at the end the following new section:
Section 28: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
SECTION 2. Chapter 32B of the General Laws is hereby amended by adding at the end the following new section:
Section 30: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
SECTION 3. Chapter 175 of the General Laws is hereby amended by inserting the following section:-
Section 47LL: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
SECTION 4. Chapter 176A of the General Laws is hereby amended by inserting the following section:-
Section 8NN: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
SECTION 5. Chapter 176B of the General Laws is hereby amended by inserting the following section:-
Section 4NN: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that a deductible shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.
SECTION 6. Chapter 176G of the General Laws is hereby amended by inserting the following new section 33:-
Section 33: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that a deductible shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.