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H 4945

An Act providing insurance coverage for biennial echocardiograms for persons under the age of 18

194th Legislature (2025-2026) Introduced by Sally Kerans

Massachusetts bill requiring insurance coverage for routine biennial heart ultrasounds in minors to enable early cardiac disease detection without cost barriers.

Reporting date extended to Thursday, December 31, 2026
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Bill Summary · H 4945

Legislative bill overview

H 4945 mandates insurance coverage for biennial (every two years) echocardiograms for individuals under 18 years old in Massachusetts. The bill treats these cardiac ultrasound screenings as a covered benefit, removing potential cost barriers for minors to receive this diagnostic imaging.

Why is this important

Echocardiograms can detect structural heart defects and cardiac conditions early in childhood, potentially preventing serious complications or sudden cardiac events. The requirement for insurance coverage removes out-of-pocket costs that might otherwise prevent families from obtaining screenings their physicians recommend, particularly for at-risk youth or those with family histories of heart disease.

Potential points of contention

  • Cost implications: Mandating coverage of routine biennial screening for all minors increases insurance premium costs; insurers may argue this expands coverage beyond evidence-based medical necessity for asymptomatic populations
  • Medical necessity debate: Questions exist about whether all children need routine biennial echocardiograms versus targeted screening for those with symptoms, family history, or identified risk factors
  • Implementation scope: Unclear whether the mandate applies to all insurance plans (commercial, Medicaid, self-insured) or how providers will manage screening volume and scheduling

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

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