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H1162 • 2025

An Act to reduce inequities in access to medical procedures

An Act to reduce inequities in access to medical procedures

Healthcare
Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor
William C. Galvin
Last action
2025-08-28
Official status
Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

An Act to reduce inequities in access to medical procedures

An Act to reduce inequities in access to medical procedures By Representative Galvin of Canton, a petition (accompanied by bill, House, No.

What This Bill Does

  • An Act to reduce inequities in access to medical procedures By Representative Galvin of Canton, a petition (accompanied by bill, House, No.
  • 1162) of William C.
  • Galvin relative to reductions of insurance payments for certain medical procedures.
  • Financial Services.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2025-08-28 Joint

    Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time

  2. 2025-07-31 House

    Accompanied a new draft, see H4338

  3. 2025-04-23 Joint

    Hearing scheduled for 04/29/2025 from 10:00 AM-02:00 PM in A-2

  4. 2025-02-27 House

    Referred to the committee on Financial Services

  5. 2025-02-27 Senate

    Senate concurred

Official Summary Text

An Act to reduce inequities in access to medical procedures
By Representative Galvin of Canton, a petition (accompanied by bill, House, No. 1162) of William C. Galvin relative to reductions of insurance payments for certain medical procedures. Financial Services.

Current Bill Text

Read the full stored bill text 
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Bill H.1162

Section 16 of chapter 176O of the General Laws is hereby amended by striking out subsection (c) and inserting in place thereof the following subsections:

(c) Carriers are prohibited from reducing the payment of a negotiated rate for evaluation and management or procedural services under a participating provider agreement that are furnished by a participating provider and that are otherwise covered services solely because the provider also billed other health care services, including but not limited to minor surgery, on the same day as the evaluation and management or procedural services. Any provision of a provider agreement that allows for a reduction in reimbursement as prohibited by this subsection shall be void.

(d) With respect to an insured enrolled in a health benefit plan under which the carrier or utilization review organization only provides administrative services, the obligations of a carrier or utilization review organization created by this section and related to payment shall be limited to recommending to the third party payor that coverage should be authorized.

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