Governor Baker signs new healthcare legislation for Massachusetts

BOSTON – Governor Charlie Baker yesterday signed comprehensive health care legislation that promotes key priorities initially included in the Administration’s health care legislation filed in 2019. The new law increases insurance coverage for telehealth services, expands the scope of practice for nurse practitioners, other specialized nurses, and optometrists, and takes steps to protect consumers from surprise medical bills. Recognizing the continuing impacts of COVID-19, the law also extends requirements for all insurance carriers in Massachusetts to cover COVID-19 testing and treatment.

The legislation signed today contains several priorities initially included in the Baker-Polito Administration’s health care legislation which was introduced in the fall of 2019, including requiring coverage of telehealth services and expanding the scope of practice for Advanced Practice Nurses. The legislation also extends, and in some instances codifies, critical measures taken through executive action throughout the pandemic to ensure timely access and coverage for COVID-19 treatment and services.

In addition to the provisions enacted today, the recently signed Fiscal Year 2021 budget includes several provisions that correspond to proposals initially introduced in the Administration’s health care legislation. These proposals require all Massachusetts insurers to use a standard credentialing form, and prohibit additional costs for same-day billing for multiple primary care and behavioral health visits.

The key provisions of the new law include:

-Requiring coverage of telehealth services including behavioral health care
-Expanding Scope of Practice for Advanced Practice Nurses and Optometrists
-Increasing disclosures around provider costs and network status to protect consumers from surprise medical bills
-Removing barriers to urgent care centers for MassHealth members
-Extending insurance coverage and access to COVID-19 testing and treatment
-Directing a study and report of the impacts of COVID-19 on the health care system

“Massachusetts has long been a leader in ensuring health care quality and access and with this new law, we are making further progress in building a strong, accessible and affordable health care system, a goal that is more important now than ever,” said Governor Charlie Baker. “I am proud to sign this legislation which promotes telehealth services that have become vital during this pandemic, expands access to high-quality, affordable care, takes steps to protect consumers from surprise medical bills, and preserves access to COVID-19 testing and treatment. We look forward to working with our partners in the Legislature and the health care community to build on these reforms in the future.”

“The legislation signed today will increase access to high quality, affordable health care for residents and families across the Commonwealth, and we thank our legislative partners for their collaboration on these important issues,” said Lt. Governor Karyn Polito. “We were pleased that many of the shared priorities that we introduced in our health care legislation were enacted as part of the final legislation and look forward to this law strengthening the Commonwealth’s health care system for years to come.”

“The COVID-19 public health emergency required immediate changes to our health care system to maintain health care capacity and help our residents cope during this extraordinarily challenging time. We’re pleased to now codify policies that help people access the treatment and services they need in our fight against COVI-19, and look forward to seeing them in action,” said Secretary of Health and Human Services Marylou Sudders. “Now more than ever do we need to ensure access to behavioral health care services, as the COVID-19 pandemic has exacerbated the need and urgency to increase behavioral health care access across the state. I applaud the Legislature for addressing several proposals to increase coverage and address barriers to necessary behavioral health services. We plan to release our behavioral health roadmap in the coming weeks and look forward to partnering with the Legislature to implement overdue reforms to ensure we have a true behavioral health system.”

“This pandemic has brought an urgency to the need to make quality healthcare more accessible to all,” said Senate President Karen E. Spilka (D – Ashland). “By eliminating barriers to care, protecting patients from surprise billing practices, and advancing our state’s support for community hospitals, testing sites and medical staff, this comprehensive legislation will equip healthcare providers to truly put patients first. I am particularly happy that rate parity for telehealth services will remain a permanent option for Massachusetts patients – thereby expanding efficiency in care while reducing stress for everyone involved. I want to offer my thanks to Senator Friedman, Speaker Mariano and their fellow conferees for their hard work, as well as former Speaker DeLeo for his partnership in advancing these significant reforms, and Governor Baker for signing this important bill.”

“This legislation applies lessons learned during the pandemic to make long-lasting changes in the way people access health care services,” said House Speaker Ronald Mariano (D – Quincy). “I want to thank Governor Baker and his Administration for signing this bill into law and for the emergency measures they implemented during the pandemic to stabilize our health care system. I also want to thank Senate President Karen Spilka and Senator Cindy Friedman for their cooperation and partnership.”

“This conference committee report embraces the best of both the Senate and House bills to create comprehensive and necessary healthcare reforms,” said Senator Cindy Friedman (D — Arlington), co-chair of the Joint Committee on Health Care Financing. “While there is still more to do to improve patient outcomes and access to care, this bill takes a meaningful step forward by ensuring that the Commonwealth’s healthcare system can continue to meet the needs of patients during this unprecedented time, and long after the COVID-19 pandemic has ended. I am grateful to the House for their collaboration and to Senate President Spilka and Chair Rodrigues for their leadership, and I want to thank Governor Baker for recognizing the importance of this legislation by signing it into law today.”

“This legislation continues to advance our shared goal of transforming mental health care access and delivery in Massachusetts,” said Senator Julian Cyr (D – Truro), co-chair of the Joint Committee on Mental Health, Substance Use and Recovery. “This legislation will do so much good, but particularly it will expand mental health care access for rural residents, people of color, working families, and young people.”

“I would like to thank Speaker Mariano, Governor Baker, and my colleagues on the Conference Committee for all of their hard work to get this incredibly important and timely piece of legislation across the finish line,” said Joint Committee on Public Health House Co-Chair Representative John J. Mahoney (D – Worcester). “As we enter these difficult months ahead in the midst of the pandemic, it is imperative that health care be as accessible and affordable as possible across the Commonwealth, and this legislation solidifies that ongoing commitment.”

“The legislation addresses several key factors in making healthcare more accessible and medical bills less surprising,” said Representative Randy Hunt (R – Sandwich). “Telehealth is here to stay and, combined with expansion of practice responsibilities, more people in more places will receive quality medical care. I especially applaud mandatory coverage for PANS and PANDAS and my heart goes out to all of the families dealing with these devastating conditions.”

“Health care is critical to the physical and mental well-being of our residents. This historic legislation will allow and expand access to Telehealth, reform the healthcare workforce, provide assistance to eligible community hospitals, increase cost transparency, provides coverage to PANDAS/PANS, eliminate barriers to urgent care facilities for MassHealth patients, and provide access to COVID-19 testing and treatment,” said Senator Dean Tran (R – Fitchburg). “It was a privilege to be on the conference committee and worked closely with my colleagues in the Senate and House, as well as with the Governor and Lieutenant Governor on this legislation to become law.”

Key provisions of the law signed today include:

Strengthening Telehealth Coverage: At the start of the COVID-19 public health emergency, the Baker-Polito Administration, through emergency order, required insurers to immediately cover telehealth to ensure the continuity of services remotely when it was not safe to do so in person. This led to a rapid shift to remote delivery and significant uptake in telehealth services. The legislation builds on these emergency flexibilities, and requires coverage parity for telehealth services and implements permanent telehealth rate parity for behavioral health services. Additionally, it requires rate parity for telehealth coverage for primary care and chronic disease management services for two years, and rate parity for all services for 90 days past the state of emergency.

Expanding Scope of Practice: During the public health emergency, the Administration implemented emergency orders to increase health care system capacity, including temporarily expanding the scope of practice for several types of practitioners, and streamlining licensure requirements before independent practice. The new law makes permanent certain measures to expand scope of practice for nurse practitioners, nurse anesthetists, psychiatric nurse mental health specialists and optometrists.

Taking Steps to Address Surprise Billing: The new legislation takes steps to protect consumers from surprise bills, including a provision that requires providers to notify patients in advance as to whether a procedure is in or out of network. Additionally, it directs the Secretary of the Executive Office of Health and Human Services to work with the Health Policy Commission, Center for Health Information and Analytics, and Division of Insurance to recommend a default rate for out of network billing by September of 2021.

Increasing Access to Urgent Care for MassHealth Members: Retail clinics and urgent care centers provide important access points to health care beyond the traditional hours and sites of physician offices, community health centers, and hospitals. This legislation takes several steps to increase MassHealth member access to urgent care sites, including eliminating referral requirements before urgent care visits and requirements for care coordination with the member’s primary care physician.

COVID-19 Related Provisions: The bill extends requirements for insurers in Massachusetts to cover COVID-19 testing and treatment. Under this legislation, insurers, including MassHealth, are required to cover all COVID-19 related emergency, inpatient, and cognitive rehab services. Additionally, coverage is required for medically necessary outpatient COVID-19 testing, including for asymptomatic individuals under specific circumstances outlined by the Secretary of the Executive Office of Health and Human Services. The legislation also directs the Health Policy Commission and Center for Health Information and Analytics to analyze and report on the effect of COVID-19 on healthcare accessibility, quality and fiscal sustainability in both the short and long term as well as those effects on long term policy considerations, including an examination of existing healthcare disparities due to economic, geographic, racial or other factors.