H1168 • 2025

An Act relative to eliminating the PCP referral requirement for specialty gynecological care

Active

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

Sponsor: Judith A. Garcia
Last action: 2026-03-19
Official status: Referred to Joint Committee on Health Care Financing
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 relative to eliminating the PCP referral requirement for specialty gynecological care

An Act relative to eliminating the PCP referral requirement for specialty gynecological care By Representative Garcia of Chelsea, a petition (accompanied by bill, House, No.

What This Bill Does

An Act relative to eliminating the PCP referral requirement for specialty gynecological care By Representative Garcia of Chelsea, a petition (accompanied by bill, House, No.
1168) of Judith A.
Garcia and Patrick Joseph Kearney relative to eliminating the health insurance referral requirement for certain specialty gynecological care.
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

2026-03-19 House
Reporting date extended to Monday, June 15, 2026
2025-12-08 House
Reporting date extended to Wednesday, March 18, 2026
2025-10-20 Joint
Hearing scheduled for 07/15/2025 from 10:00 AM-01:00 PM in A-2
2025-10-20 House
Reported favorably by committee and referred to the committee on Health Care Financing
2025-07-03 Joint
Hearing scheduled for 07/15/2025 from 10:00 AM-01:00 PM in A-2
2025-02-27 House
Referred to the committee on Financial Services
2025-02-27 Senate
Senate concurred

Official Summary Text

An Act relative to eliminating the PCP referral requirement for specialty gynecological care
By Representative Garcia of Chelsea, a petition (accompanied by bill, House, No. 1168) of Judith A. Garcia and Patrick Joseph Kearney relative to eliminating the health insurance referral requirement for certain specialty gynecological care. Financial Services.
Status:
Referred to Joint Committee on Health Care Financing

Current Bill Text

Read the full stored bill text

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Bill H.1168

Subsection (g) of section 15 of chapter 176O of the General Laws, as appearing in the 2022 Official Edition, is hereby amended by striking out the first sentence and inserting in place thereof the following sentence:- No carrier shall require an insured to obtain a referral or prior authorization from a primary care provider for specialty care provided by an obstetrician, gynecologist, certified nurse-midwife or family practitioner participating in such carrier's health care provider network for the following: (i) annual preventive gynecologic health examinations, including any subsequent obstetric or gynecological services determined by such obstetrician, gynecologist, certified nurse-midwife or family practitioner to be medically necessary as a result of such examination; (ii) preventative gynecologic health care and menstrual health conditions such as abnormal uterine bleeding, dysmenorrhea and pelvic pain; (iii) maternity care; and (iv) medically necessary evaluations and resultant health care services for acute or emergency gynecological conditions.

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