Author: john_velis

Bill enhances oversight, requires outbreak planning, and creates an LGBTQ+ Bill of Rights

(BOSTON—7/25/2024) The Massachusetts Senate today approved sweeping reforms to the Commonwealth’s long term care and assisted living sectors, taking a powerful step towards delivering the high quality and safe care that Massachusetts seniors deserve. S.2889, An Act relative to long term care and assisted living, substantially strengthens oversight and enforcement while also requiring facilities to create outbreak plans should a health issue arise.

The bill also creates an LGBTQ+ bill of rights for aging residents to prohibit discrimination based on their LGBTQ+ identity or HIV status. After robust debate, the bill passed 39-0.

“Today the Senate took an important step forward to ensure that our aging residents have safe, equitable, and high-quality care,” said Senate President Karen E. Spilka (D-Ashland). “It is far too common—and unacceptable—for residents in assisted living facilities to receive subpar care. By boosting transparency and accountability, the Senate is continuing to create a compassionate Commonwealth where all residents can age with dignity. I am grateful to Senator Jehlen for her leadership on this legislation, Chair Rodrigues, and each of my colleagues for their support of our state’s residents.”

“Long term care reform was a long-standing priority for the Senate this session, and I’m glad we were able to get it done,” said Senator Michael J. Rodrigues (D-Westport), Chair of the Senate Committee on Ways and Means. “This comprehensive package passed by the Senate today addresses many of the inequities that are prevalent in the long term care sector. With this legislation, we will now have a much stronger licensure process and stricter oversight on non-performing entities. We also make permanent basic health services at assisted living facilities. This reform bill will bring much needed stability into long term care and assisted living facilities across the Commonwealth.”

“I am grateful to all those—Senate leaders, legislators, and so many advocates and industry representatives—who have worked for many years to pass this bill that will improve care and stability in nursing homes and assisted living residences,” said Senator Patricia D. Jehlen (D-Somerville), Senate Chair of the Joint Committee on Elder Affairs. “The pandemic revealed starkly the lack of nursing home preparedness for the spread of fatal diseases. Many of us knew someone or relatives of someone who passed during that disaster. Even homes with consistently high ratings lost many residents. This bill offers measures to address issues in nursing homes and assisted living facilities; issues faced by the LGBTQ+ community when looking for care; bariatric care; and pooled trusts. It also ensures facilities that are not compliant with safe

standards face consequences and are held responsible. I am grateful for the work of the Senate President, the Chair of Senate Ways and Means, my staff, and the many advocates that we have worked with and heard from over the years.”

The bill includes provisions related to basic health services administered in assisted living facilities and oversight of long term care facilities, including the following.

Assisted Living Basic Health Services. The bill makes it easier for residents of nursing homes and long term care facilities to get timely and efficient care by allowing Assisted Living Residences (ALRs) to offer basic health services such as helping a resident administer drops, manage their oxygen, or take a home diagnostic test. The legislation requires ALRs create service plans that demonstrate the residence has the necessary procedures in place, such as staff training and policies, to ensure safe and effective delivery of basic health services.

The legislation enhances oversight and compliance of ALRs by lowering the threshold for ownership interest disclosure from 25 per cent to five per cent. Under the new law, applicants are required to demonstrate that any prior multifamily housing, ALR, or health care facilities in which they had an interest met all the licensure or certification criteria. If any of these facilities were subject to enforcement action, the applicant must provide evidence that they corrected these deficiencies without revocation of licensure or certification.

This bill also gives the Executive Office of Elder Affairs (EOEA) new powers to penalize non-compliance by allowing them to fine ALRs up to $500 per day. This is in addition to existing EOEA powers to modify, suspend, or revoke a certification, or deny a recertification. Finally, it adds whistleblower protections for staff and residents who report anything happening at an ALR that they reasonably believe is a threat to the health or safety of staff or residents.

Long Term Care Facilities. The bill requires the Department of Public Health (DPH) to inspect each long term care facility every nine to 15 months to assess quality of services and compliance. It also requires DPH to review the civil litigation history, in addition to the criminal history, of the long term care facility applicants, including any litigation related to quality of care, patient safety, labor issues, or deceptive business practices.

S.2889 requires DPH to review the financial capacity of an applicant and its history in providing long term care in Massachusetts and other states. It requires applicants to notify DPH if it is undergoing financial distress, such as filing for bankruptcy, defaulting on a lending agreement, or undergoing receivership.

It allows DPH to limit, restrict, or revoke a long term care facility license for cause, such as substantial or sustained failure to provide adequate care, substantial or sustained failure to comply with laws or regulations, or lack of financial capacity to operate a facility. It also gives DPH the power to appoint a temporary manager if a long term care facility owner fails to maintain substantial or sustained compliance with laws and regulations. This manager would be brought on for at least three months, at the facility owner’s expense, to bring the facility into compliance.

The bill requires long term care facilities to submit outbreak response plans to DPH with clear protocols for the isolation of residents, lab testing, visitor screening, preventing spread from staff, and the notification of residents, family, and staff in the event of a contagious disease outbreak.

The bill prohibits long term care facilities from discriminating against residents based on LGBTQ+ identity or HIV status, whether through the denial of admission, medical or non-medical care, access to restrooms, or through room assignments. It also requires staff training on preserving LGBTQ+ rights and care.

Versions of the bill having passed both chambers of the Legislature, the two branches will now reconcile their differences before sending a bill to the Governor’s desk.

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Bill boosts salary transparency, tackles unfair compensation for women and people of color 

(BOSTON—7/24/2024) Today the Massachusetts Legislature took a powerful step towards closing the gender and racial wage gap in the Commonwealth by passing An Act relative to salary range transparency. The legislation requires employers with 25 or more employees to disclose a salary range when posting a position and protects an employee’s right to ask their employer for the salary range for their position when applying for a job or seeking a promotion. 

When signed into law H.4890 would make Massachusetts the eleventh state to mandate pay transparency by requiring employers to disclose salary ranges, according to the National Women’s Law Center. H.4890 builds on the Legislature’s 2016 passage of the Massachusetts Equal Pay Act, which prohibited wage discrimination based on gender and brought long-sought fairness and equality to workplaces in the state. 

“With the passage of this legislation, Massachusetts is now one step closer to ensuring equal pay for equal work,” said House Speaker Ronald J. Mariano (D-Quincy). “Pay transparency will not only make our workplaces more equitable, it will also make Massachusetts more competitive with other states. I’d like to thank Leader Gregoire and the members of the conference committee, as well as all my colleagues in the House, Senate President Spilka and our partners in the Senate, for their important work on this legislation.” 

“This is simple: everyone deserves equal pay for equal work, regardless of your gender, race, ethnicity, or background,” said Senate President Karen E. Spilka (D-Ashland). “It is far too common for women and people of color to be paid less than their coworkers nationwide, and Massachusetts is not immune. By passing this bill, the Legislature stands united behind every worker—and with every business—in our steadfast commitment to the fundamental principle that every person has the right to be treated and compensated fairly in the workplace. I’m thankful to Senator Jehlen for her work on the conference committee, each of the conferees, Speaker Mariano, and our partners in the House for their work on this critical legislation.” 

“With the passage of this conference report we are doubling down on our commitment to wage equity in the Commonwealth, ensuring a level playing field and competitive salaries for employees,” said Representative Danielle W. Gregoire (D-Marlborough), First Division Chair and House Chair of the Conference Committee. “As a late addition to this conference committee due to the result of the departure of Chairman Cutler, I am grateful to my House and Senate colleagues who have worked tirelessly to ensure that this bill reaches the Governor’s desk prior to the end of the legislative session.” 

“The 2016 Equal Pay Act was a huge step forward in closing pay gaps and it worked. One study from 2020 showed salary history bans alone increased pay by as much as 5% increase for all job changers, an 8% increase for women and a 13% increase for Black workers,” said Senator Patricia D. Jehlen (D-Somerville), Senate Chair of the Conference Committee. “This bill takes the next steps in providing more information for job seekers and ensuring that women and people of color enter wage negotiations with more information at their fingertips to secure better offers. With the data collected we’ll learn about inequities that persist and be able to identify ways to solve them. I’m grateful this was a priority of both the House and the Senate and for the work of my colleagues and look forward to this bill being signed by Governor Healey.”  

The bill requires employers with more than 100 employees to share their federal wage and workforce data reports with the Executive Office of Labor and Workforce Development (EOLWD), which would then be responsible for compiling and publishing aggregated wage and workforce date to help identify gender and racial wage gaps by industry. 

In Greater Boston, the 2023 gender wage gap was 21 cents, according to the Boston Women’s Workforce Council. This gap becomes more pronounced when comparing white men and women of color, where Black/African American women face a 54-cent wage gap, Hispanic/Latina women face a 52-cent wage gap, and Asian women face a 19-cent wage gap. 

“True progress towards justice and equality demands that we not only acknowledge the critical importance of wage equity, particularly for women and people of color, but actively strive to achieve it,” said Representative Brandy Fluker Oakley (D-Mattapan), House Conferee and sponsor of the bill. “By achieving wage equity, we empower individuals and strengthen our communities, fostering an environment where everyone can thrive and contribute to a more equitable future.” 

“I am proud of this Conference Committee for working collaboratively, productively, and diligently to reach a final agreement on the historic and nation-leading wage equity legislation we enacted today,” said Senator Paul R. Feeney (D-Foxborough), Senate Conferee and sponsor of wage transparency legislation that was folded into the underlying bill. “Wage and income inequality continues to exacerbate an uneven economy for working people, especially women and people of color. By instituting salary range transparency in job descriptions and collecting aggregate demographic data to track wages across industries, we can empower workers and begin to close the gender and racial wage gap that persists across our economy and erodes the integrity of work. I thank the coalition of labor, community, and business leaders, under the guidance and unwavering persistence of former Lt. Governor Evelyn Murphy, for working together to refine this legislation and ensure that Massachusetts will continue to attract and retain the skilled and diverse workforce that keeps our economy humming and our Commonwealth thriving.” 

“This legislation is an important step to eliminate gender and racial wage gaps,” said Representative Hannah Kane (R-Shrewsbury), a House Conferee. “Providing information on the salary range for a position will help women and people of color negotiate for better pay, and as the House Chair of the Massachusetts Caucus of Women Legislators, I am excited that one of the Caucus’ priority bills is closer to becoming law. I thank House and Senate leadership, and my fellow conferees, for their work to advance this legislation.” 

“I am supportive, as always, of legislation which promotes equity and fairness within our Commonwealth. This Act provides the language which entitles the Massachusetts workforce to access imperative information regarding salary ranges, fostering a job market which is not only more transparent, but more inclusive” said Senator Patrick M. O’Connor (R-Weymouth), a Senate Conferee. “In requiring employers to disclose pay ranges, alongside making aggregate wage data information public, this is an important step forward in closing the wage gap. I am looking forward to continuing to work to advance important reforms in pay equity. Ensuring equal opportunity for all Massachusetts workers is beneficial not just to those employees of the state, but to our overall economy.” 

Having passed both chambers, the bill now goes to the Governor’s desk for her signature. 

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Legislation authorizes $1.26B in bonds, allocates $400M in federal funds

(BOSTON—7/24/2024) Today the Massachusetts Legislature enacted the FutureTech Act, taking action on a $1.26 billion bond authorization to modernize the Commonwealth’s digital infrastructure and create safer and more accessible experiences for residents and employees alike.

Funding and projects included in H.4889, An Act to provide for the future information technology needs of Massachusetts, would allow state agencies to deliver services more efficiently to residents, enhance cybersecurity on statewide platforms, and broaden access to services used by hundreds of thousands of residents statewide. The bill would also invest in emerging technologies and artificial intelligence (AI) and create a fund to secure anticipated federal funding to bolster health and human services-related projects.

“Today the Legislature is investing in a safer, more efficient, and modernized digital experience for residents and state employees alike,” said Senate President Karen E. Spilka (D-Ashland). “Our technology infrastructure is a lynchpin for nearly every service and resource our state delivers, and enhancing it is a fundamental step toward increasing access and creating systems that work for everyone. I’m grateful to Senator Comerford for her leadership on the conference committee, as well as the conferees, Speaker Mariano, and our colleagues in the House, and I look forward to the Governor signing this important bill into law.”

“Ensuring that the Commonwealth is investing heavily in our technology infrastructure is critical, as protecting against cybersecurity threats, and enabling state agencies to operate with an increased level of efficiency, are vital aspects of our effort to make Massachusetts more safe, effective, and prepared in a world dominated by increasingly sophisticated technologies,” said House Speaker Ronald J. Mariano (D-Quincy). “I want to thank Governor Healey for filing this legislation, as well as Chairman Finn and each member of the conference committee for their critical input, and for guiding this bill through the legislative process. I am grateful to all of my colleagues in the House, and to Senate President Spilka and our partners in the Senate, for recognizing the importance of this bill, and for voting to send it to the Governor’s desk for her signature.”

“The FutureTech Act will help position Massachusetts as a leader in current and emergent technologies,” said Senator Jo Comerford (D-Northampton), Senate Chair of the Conference Committee. “This legislation will modernize the Commonwealth’s digital infrastructure with an eye toward accessibility, equity, and emerging technologies. I am grateful for the partnership of House chair Michael Finn and the Senate conferees, Senator Ed Kennedy and Minority Leader Bruce Tarr, for their work to achieve a strong bill. I am also thankful to Senate President Karen Spilka for the opportunity to chair this conference committee on behalf of the Senate.”

“The passage of the FutureTech Act of 2024 signifies Massachusetts’ commitment to modernizing our information technology infrastructure, enhancing our cybersecurity efforts, and ensuring a brighter, more interconnected future for our residents,” said Representative Michael J. Finn (D-Springfield), House Chair of the Joint Committee on Bonding, Capital Expenditures and State Assets and House Chair of the Conference Committee.

“This important legislation takes major steps towards improving the Commonwealth’s digital infrastructure,” said Senator Edward J. Kennedy (D-Lowell), a member of the conference committee. “Because of these investments, the residents of Massachusetts will benefit from a safe and modern informational technology environment in all state agencies. I’m grateful to Senate President Karen Spilka and my colleagues on the conference committee for their collaboration in developing a final version of this legislation.”

“The FutureTech Bond Bill is a forward-looking bill that ensures that the Commonwealth’s technology infrastructure is up to date and secure. These investments in innovative technologies will improve the efficiency of state government and benefit everyone in Massachusetts,” said Representative Danielle W. Gregoire (D-Marlborough), First Division Chair and a member of the conference committee.

“Information technology is essential to the operations of our state, and it must be efficient, secure, and as user friendly as possible,” said Senate Minority Leader Bruce Tarr (R-Gloucester), a member of the conference committee. “The investments and policy measures in this bill will contribute to the advancement of those goals.”

“I am immensely proud of the dedication and effort demonstrated by the conference committee to bring this report to fruition,” said Representative Marcus S. Vaughn (R-Wrentham), a member of the conference committee. “This achievement stands as a testament to the power of collaboration. By working together, we have shown our shared commitment to serving the best interests of the Commonwealth.”

The FutureTech Act lays a foundation for technology innovation in the Commonwealth by implementing transformative projects like the Business Enterprise Systems Transformation (BEST) and the Commonwealth Digital Roadmap, both of which would be targeted at streamlining state operations and making essential government services quicker and more efficient.

It would support a new project to consolidate and modernize the Division of Occupational Licensing’s (DOL) licensing database, which currently relies on outdated infrastructure, paper files, and manual data entry. Once full implemented, new systems will accelerate licensing and renewals.

The bill also includes authorizations to continue investments for the Employment Modernization Transformation (EMT) rollout, which will provide employers and those seeking unemployment insurance with a new portal to manage unemployment insurance claims. With phase one already rolled out, future improvements will include easier uploads, a mobile-friendly design, and enhanced accessibility features.

The FutureTech Act builds on Massachusetts’ longstanding leadership in emerging technology by allocating funds for future AI projects and supporting initiatives like the Municipal Fiber Grant Program, which boosts innovation and extends efficiencies to cities and towns.

Having passed both branches of the Legislature, the legislation will now be sent to the Governor’s desk for her signature.

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Bill ensures firefighters, police officers, and EMTs receive pay after injury from violent acts

(BOSTON—7/24/2024) Today the Massachusetts Senate unanimously passed legislation to ensure that first responders who are permanently injured by violent acts in the line of duty receive their full regular compensation until they reach retirement age. S.2887, An Act relative to disability pensions and critical incident stress management for violent crimes, enshrines into law financial security for first responders and their families after a critical or life-threatening injury occurs while serving their state, county, city, or town.

“Every day when our first responders leave for work, they do so not knowing what the day will bring,” said Senate President Karen E. Spilka (D-Ashland). “Today, the Senate has acted to ensure that these first responders and their families have financial security if the unthinkable does happen before they return home. I’m grateful to Senator Friedman for her leadership on this legislation, Chair Rodrigues, and all of my colleagues for their support.”

“I’m pleased that the Senate has closed this loophole in the Commonwealth’s retirement system by installing full accidental disability retirement benefits for injuries sustained by violence upon a first responder,” said Senator Michael J. Rodrigues (D-Westport), Chair of the Senate Committee on Ways and Means. “Our brave first responders deserve this protection, as they put their lives on the line every day and are often subject to violent attacks while performing their jobs. Any member who sustains permanent bodily injury should not have their retirement compensation penalized if they are a victim of a violent attack.”

“The push for authorizing full disability pensions for first responders violently injured on duty dates back to my time working with and for my predecessor, Senator Ken Donnelly,” said Senator Cindy F. Friedman (D-Arlington), Vice Chair of the Senate Committee on Ways and Means. “As a former firefighter, there was no bigger advocate of honoring the service and sacrifice of Massachusetts’ first responders than Ken, and I am honored to have been able to play a role in getting this bill through the Senate, further cementing Ken’s incredible legacy. This legislation will change the lives of first responders and their families in the Commonwealth who have had to suffer through tremendous hardship.”

The legislation authorizes any employee considered a member-in-service of a retirement board to be eligible for accidental disability retirement if they sustain a catastrophic, life-threatening, or life-altering and permanent bodily injury, and are no longer able to perform their duties. Retirement boards would review evidence deemed appropriate, such as a medical panel finding that the member is physically unable to perform the essential duties of their job due to a violent act injury, and that this inability is likely to be permanent.

The bill also requires that following any incident involving exposure to actual or threatened death, serious injury, or sexual violence, a member must receive notice of critical incident stress management debriefing programs. This provision ensures that first responders have access to the mental health support they need after traumatic events.

Having previously been passed by the House, the bill will need one more enacting vote in each branch before being sent to the Governor for her consideration.

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Hello Everyone, 

I hope you have all been enjoying the summer weather this week.  Just a reminder that should you need help finding a cooling center near you, my office is ready and happy to assist.   

We’ve had a busy schedule here in the Senate as we approach the end of the legislative session.  My team and I have been hard at work this week as we review the legislature’s recent healthcare reform package.  The affordability and accessibility of healthcare is one of the most pressing issues facing the Commonwealth and this bill takes aim at expanding both.  I was proud to have worked on this alongside my fellow legislators and look forward to continuing this work throughout the rest of session.     

Outside of my work on Beacon Hill, my team and I were busy throughout this week attending some fantastic community events.  Monday afternoon, I had the honor of presenting a citation to Rose O’Brien of West Springfield at the Council on Aging in recognition of her “Gold Cane” award.  This honor is bestowed upon the citizen of West Side who has lived in the town the longest and embodies best what it means to be a member of the community.  Congratulations Rose!  

Tuesday morning, my staff accompanied Secretary Ed Augustus of the Executive Office of Housing and Livable Communities for a tour of the Treehouse Intergenerational community in Easthampton as well as a tour of the Easthampton Housing Authority.  Treehouse is such a wonderful neighborhood that brings together older adults and youth in the foster care system for a truly special and supportive community. Thank you to Secretary Augustus for coming all the way out to Western Mass for these tours.   

Wednesday evening, I was joined by Governor Healey, Secretary of the Executive Office of Energy and Environmental Affairs Rebecca Tepper, and DCR Commissioner Brian Arrigo to play some basketball at the Holyoke Boys and Girls Club as a part of the DCR’s Summer Nights program.  This program aims at to provide our urban youth with opportunities to organize and play sports in the evening outside of normal DCR program hours.  Summer Nights provides such an essential service to kids here in the Valley and I was lucky to have been invited to play.   

This week my team hosted office hours at the Easthampton COA on Tuesday and at the Holyoke COA.  Next week, we will be at the Westfield COA on Monday from 12:30pm to 1:30pm and at the Russell COA on Tuesday from 11:30am to 12:30pm.  If you can’t make office hours, I can always be reached by email, john.velis@masenate.gov, by phone, (413) 572-3920, and you can find me online at senatorjohnvelis.com.  

Sincerely,  

John Velis 

Bill strengthens health care market oversight and imposes guardrails on private equity investments

(BOSTON—7/18/2024) Today the Massachusetts Senate passed urgent reforms to the Commonwealth’s health care system to boost oversight and transparency in the market and improve patient access to prescribed medication and treatment.

Following debate, the Senate approved the legislation by a vote of 38-2.

The reforms in S.2871 come as Massachusetts continues to manage challenges related to private equity’s mismanagement in health care, which has created uncertainties for patients receiving care and the communities that the healthcare facilities serve. The legislation passed by the Senate would create strong systemic safeguards around private equity in healthcare, a significant step towards preempting future mismanagement.

“Massachusetts is the health care capital of the world because we take seriously our responsibility to invest in and protect our systems, providers, and patients,” said Senate President Karen E. Spilka (D-Ashland). “As we stare down a health care market plagued by high costs and the fallout from private equity mismanagement, the Senate has doubled down on our responsibility to our residents, making us a national leader in safeguarding patients, expanding access to care, and holding private equity accountable. I’m grateful to the unmatched work of Senator Friedman, the work of my colleagues, and the countless advocates who have contributed their voices to this legislation.”

“I’m pleased that the Senate has taken an expansive overhaul of the Commonwealth’s struggling health care system with this regulatory redress bill,” said Senator Michael J. Rodrigues (D-Westport), Chair of the Senate Committee on Ways and Means. “The collapse of Steward Health Care shows us that it’s now time to reform the system and make transparent the process of costs in relation to services rendered to patients. While Massachusetts is known throughout the world as providing the very best in health care, this

legislation will make that care more affordable and accessible. I thank Senator Freidman for her work in bringing this cost containment bill to the full Senate for its consideration.”

“The Senate’s comprehensive health care market legislation passed today puts patients and providers back into the focus of the delivery of healthcare, rather than profits,” said Senator Cindy F. Friedman (D-Arlington). “To ensure that a crisis similar to that surrounding Steward Health Care does not infiltrate our state’s health care system ever again, this bill modernizes and strengthens the health care oversight and transparency tools we have in the Commonwealth. This bill also provides protections for patients and providers, affords our health care regulatory agencies the needed flexibility and scope to oversee the industry as it evolves, and increases the financial transparency of major market players. I thank Senate President Spilka, Chair Rodrigues, and my Senate colleagues for their attention to these issues. Residents of Massachusetts deserve health care that is accessible, affordable, and high quality, and this bill continues the Senate’s goal to deliver just that.”

Provisions of An Act enhancing the health care market review process include:

Expanding oversight of Private Equity. Leading nationwide efforts, the bill expands oversight of private equity firms, real estate investment trusts (REITs), and management services organizations (MSOs) involved with Massachusetts health care providers and provider organizations. In conjunction with the Senate’s efforts to rein in the costs of prescription drugs through the PACT Act, the bill expands oversight of pharmaceutical manufacturing companies and pharmacy benefit managers (PBMs) and creates a licensing structure for PBMs.

In addition to PBMs, the bill establishes licensing structures for certain health care providers currently not licensed, and therefore not subject to Department of Public Health (DPH) oversight, including office-based surgical centers, urgent care centers, and health care practices.

Improving Access to Primary Care. Access to primary care is proven to reduce health care costs, yet there is an extreme shortage of primary care providers in Massachusetts and across the country. To understand how to best build a sustainable primary care system, the bill establishes a task force to study and make recommendations to stabilize the system and workforce, increase financial investment in primary care, and improve patient access to primary care.

The bill moves state health planning to the Health Policy Commission (HPC) and the health care resources inventory to the Center for Health Information and Analysis (CHIA) to better align with the work of these agencies. In developing the state health plan, HPC is directed to consider health equity goals. The bill also directs HPC and CHIA to set and measure health care affordability goals for the Commonwealth.

Keeping Health Insurance Affordable. The bill establishes a health insurance bureau within the Division of Insurance (DOI) to conduct rate reviews of premium rates for health benefit plans, oversee the small group and individual health insurance market and affordable health plans—including coverage for young adults—and disseminate information to consumers about health insurance coverage.

Cutting Red Tape for Prescription Access. In response to an increased number of consumer reports of delays accessing medications due to the need for prior authorizations, the bill requires a new insurance carrier to honor any prior authorizations approved by a previous carrier for at least 90 days following a patient’s enrollment in the new health plan. The bill also requires that a prior authorization approval for medication and treatment prescribed for chronic disease management must be valid for the length of the prescription, up to 12 months.

Strengthening the Health Policy Commission (HPC). To strengthen the HPC’s work to advance a transparent and equitable health system, the bill adds members with expertise in hospital administration and in the development and pricing of pharmaceuticals, biotechnology, or medical devices to its Board of Commissioners.

The bill adjusts the HPC’s setting of the health care cost growth benchmark—the limit of how much the HPC believes health care costs should grow over time—from one year to two years, to better account for irregularities in costs.

Boosting Transparency at the Center for Health Information and Analysis (CHIA). To increase transparency, the bill authorizes CHIA to collect information from additional health care entities such as pharmaceutical companies and pharmacy benefit managers. The bill strengthens HPC’s and CHIA’s ability to ensure compliance with data reporting requirements by health care entities by enhancing the penalties for non-compliance.

Protecting Practitioner Autonomy. This bill prevents businesses, such as MSOs and corporate employers of health care practitioners, from encroaching on the clinical autonomy of practitioners. While MSOs were created to provide practices with administrative and business support, in recent years, private equity firms and other corporations have started using MSOs to increase profits by controlling practices, and by extension, the practitioners who work in them. Patients deserve safe and appropriate care that is based on a practitioner’s best professional judgment without the influence of business interests.

Managing Costs and Improving Quality of Care. The bill updates several programs aimed at constraining health care costs and improving care quality, including the Determination of Need (DoN), Performance Improvement Plan (PIP), and Material Change Notice (MCN), and programs.

Determination of Need. This bill increases coordination between state agencies involved in health care market review by clarifying that DPH should not act on a DoN application until HPC, CHIA, the Attorney General, or other relevant agencies have been given reasonable opportunity to supply required information. This change will ensure that DPH has all the information it needs to more fully assess a proposal’s potential impact on the provision of health care in the Commonwealth.

Performance Improvement Plan. The PIP is a process by which HPC can require entities that have exceeded the cost growth benchmark to reduce their spending. The bill provides more flexibility for CHIA to refer health care entities with excessive spending to HPC, which can require the referred entity to file and implement a PIP. In addition, the HPC is given new authority to assess a civil penalty instead of requiring a PIP.

Material Change Notice . A MCN is a requirement for providers and provider organizations to notify HPC of a proposed change to their operations or governance structure at least 60 days before the change is to go into effect. The bill adds new types of transactions that require a MCN, including significant new for-profit investment and acquisitions by for-profit entities, such as large for-profit physician organizations and private equity firms, as well as the sale of assets for the purposes of a lease-back arrangement.

Crucially, the bill gives HPC new authority to require providers to address concerns that their proposed change will significantly increase consumer costs, reduce the quality of care, or reduce access to services.

A previous version of this bill having passed the House of Representatives, the two branches will now reconcile the differences between the bills, before sending it to the Governor’s desk.

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