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HD 2242

An Act prohibiting surprise outside billing

194th Legislature (2025-2026) Introduced by Kim Ferguson and 4 co-sponsors

Massachusetts bill prohibits surprise out-of-network medical bills, requiring transparent pricing and limiting patient liability for emergency care and services at in-network facilities.

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Bill Summary · HD 2242

Legislative bill overview

HD 2242 prohibits "surprise billing" practices where patients receive unexpected bills from out-of-network providers for emergency or non-emergency medical services. The bill requires transparent pricing disclosure and limits patient financial liability when they cannot control provider network selection, particularly in emergency situations.

Why is this important

Surprise medical bills are a leading cause of medical debt in the U.S., often leaving patients with thousands in unexpected costs despite having insurance. This bill addresses a genuine consumer protection gap where patients cannot realistically shop for in-network providers during emergencies or when receiving care at in-network facilities that employ out-of-network staff.

Potential points of contention

  • Provider compensation concerns: Out-of-network providers may argue reduced reimbursement rates limit their ability to practice, potentially affecting specialist availability in certain regions
  • Implementation costs: Healthcare systems and insurers face administrative expenses to implement new billing protocols, compliance systems, and dispute resolution mechanisms
  • Scope limitations: The bill's effectiveness depends on how broadly it's defined—unclear whether it covers all scenarios (air ambulances, ancillary services, etc.) or has significant carve-outs

Compiled from official sources — confirm details with the bill’s official record.

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