State Legislature Passes Bill to Improve Healthcare Access And Affordability

Senator Jason Lewis recently joined his colleagues in the Massachusetts House and Senate in voting to pass An Act promoting a resilient health care system that puts patients first. This legislation expands patient access to quality, affordable care in Massachusetts. The bill was signed into law by Governor Baker on January 1, 2021.

The bill ensures that telehealth services will continue to be available even after the pandemic is over; broadens the scope of practice for certain health care professionals; requires advance notice of a provider’s network status in order to avoid surprise medical bills for patients; and improves coverage for COVID-19 testing and treatment. Also included in this legislation are two bills that were sponsored by Senator Lewis:

  • A bill to require health insurance coverage for all medically-necessary treatments for children suffering from PANDAS/PANS
  • A bill to add a nurse to the board of the state’s Health Policy Commission

“Access to high quality, affordable healthcare for all should be a basic human right,” said Senator Jason Lewis, who previously served as the Senate Chair of the Public Health Committee. “I’m thrilled that among many important provisions, like expanding access to telehealth, this legislation includes the bill I championed to ensure that children and families struggling with PANDAS/PANS will now have access to all necessary treatments. I’m very grateful to Melrose constituent Sheilah Gauch and her courageous family for helping lead the campaign that made this legislative victory possible.”

This comprehensive healthcare bill includes the following provisions:

  • Requires behavioral health treatment delivered via telehealth to be permanently reimbursed by insurers at the same rate as in-person services. A similar reimbursement structure will also be implemented for primary care and chronic disease management services delivered via telehealth for at least two years. The bill also includes an analysis of telehealth coverage and payment to inform future policy decisions.
  • Authorizes nurse practitioners, nurse anesthetists and psychiatric nurse mental health specialists to practice independently, provided that they meet certain education and training standards, and practice under physician supervision for at least two years.
  • Ensures that COVID-19 testing and treatment services are as widely accessible as possible, with critical services covered by insurance carriers at no cost to patients.
  • Increases protections for patients against the unfair practice of surprise medical billing for out-of-network services.
  • Requires insurance carriers to cover pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndromes (PANS), and establishes a PANDAS/PANS Advisory Council within the Department of Public Health
  • Provides additional financial assistance to certain community hospitals for two years to help mitigate the unprecedented financial challenges community hospitals continue to face during the COVID-19 pandemic
  • Eliminates a barrier to participation in cancer clinical trials by allowing reimbursement for a cancer patient’s reasonable travel and accommodation expenses associated with participating in a cancer clinical trial
  • Eliminates a barrier to access urgent care services for low-income residents by ending the requirement that MassHealth patients first obtain a referral from a primary care provider before seeking care at an urgent care facility
  • Ensures that a registered nurse is a member of the Health Policy Commission’s board
  • Establishes a Rare Disease Advisory Council