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H 4258

An Act relative to allowing spouses to serve as paid caregivers

194th Legislature (2025-2026) Introduced by Tackey Chan and 1 co-sponsor

Authorizes MassHealth to allow spouses to be paid caregivers for home-based care, with officials pursuing any required federal approvals within six months of enactment.

Hearing scheduled for 10/21/2025 from 01:00 PM-05:00 PM in B-1
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WeVote Research Nonpartisan
Bill Summary · H 4258

Summary: H 4258 — An Act relative to allowing spouses to serve as paid caregivers

Purpose and intent

  • The bill seeks to authorize the Massachusetts MassHealth program to allow spouses to serve as paid caregivers for individuals receiving home-based care and services.
  • It directs state officials to take action, including seeking any required federal approvals, to implement this authorization.

Key provisions

  • Notwithstanding any general or special law to the contrary, the secretary of health and human services, in conjunction with the secretary of aging and independence, shall take action to permit spouses to serve as paid caregivers in MassHealth home-based care and services.
  • If federal approvals are required to implement this provision, they shall be filed (sought) no later than six months after the act’s effective date.
  • The bill does not specify eligibility criteria, compensation rates, or programmatic details beyond authorizing the pursuit of approval to allow spouses to be paid caregivers.

Who/what is affected

  • MassHealth beneficiaries who receive home-based care and services, and their spouses who would potentially provide paid caregiving.
  • MassHealth program administration and the involved state secretaries (Health and Human Services; Aging and Independence) responsible for implementing and seeking federal approvals.
  • Potential impact on family dynamics, caregiver employment, and Medicaid home-care labor policies.

Implementation and timeline

  • Effective date: Not stated in the text provided; conformance would trigger a six-month window to file any required federal approvals.
  • Federal approvals: If required, must be filed within six months after the act’s effective date.
  • Legislative process and status:
    • Introduced: March 27, 2025
    • Filed: March 21, 2025
    • Referred to House Rules (3/27/2025)
    • Reported and referred to the committee on Children, Families and Persons with Disabilities (4/3/2025)
    • Senate concurred (7/31/2025)
    • Hearing scheduled: October 21, 2025, from 1:00 PM to 5:00 PM (B-1)
  • Related bill: HD 4524, which replaces the current measure; this is reflected in the House docket numbering (H 4258, HD 4524).

Additional context

  • The bill emphasizes streamlined action by the administration to enable spouses to be paid caregivers, contingent on any necessary federal approvals.
  • The text is concise and primarily focuses on authorizing action and pursuing federal approvals rather than detailing implementation specifics within Massachusetts.

If you’d like, I can add a quick comparison to existing MassHealth rules on paid caregiving or draft potential questions a committee hearing might examine (e.g., caregiver qualifications, compensation safeguards, fraud prevention).

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

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