Legislative activities on Beacon Hill are expected to move into high gear as we enter the final year of the 2023/2024 session. With formal sessions ending July 31, the window of opportunity to see passage of legislation now begins to narrow.

MSCO continues to push for action on our key legislative agenda:

• H.1074 & S.689, “An Act Relative to Cancer Patient Access to Biomarker Testing to Provide Appropriate Therapy” 

expands access to biomarker testing in the Commonwealth by requiring health insurers to cover such testing that meet nationally recognized criteria for such testing.

• H.1143 & S.1249 , “An Act to Improve the Health Insurance Prior Authorization Process”

· Prohibits insurers from retrospectively denying or revoking services when authorization already granted;

· Requires prior authorization approval to be valid for duration of treatment;

· Now, prior authorization determination within 2 business days. Bill would require determinations within 24 hrs. for urgent care;

· Insurers required to report prior authorization statistics to the state on services subject to prior authorization, % of approvals/denials, and % of approvals upon appeal. This will allow regulators and the public to understand the magnitude of the administrative burden of prior authorization on the delivery of health services.

• H. 953 & S. 609 “An Act Relative to Consumer Deductibles”

bans co-pay accumulator programs in Massachusetts.

• S.598 & H.1041, “An Act Relative to Preserving Fertility”

require insurance coverage of embryo, oocyte and sperm cryopreservation procedures for an insured patient who is at least age 18 and has been diagnosed with cancer but has not started cancer treatment.

• H.982 “An Act Relative to Non-medical Switching”

· would protect Massachusetts patients from non-medical switching of medications.

· prohibits health insurers from forcing a patient in the middle of the policy year to switch from a covered prescription drug to another medication as a result of an insurer’s decision to remove a covered prescription drug from its list of covered drugs or reclassify such drug to a more restrictive drug tier with a much higher co-pay

Report provided by Edward J. Brennan, Esq., MSCO Legislative Counsel