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HD 866

An Act relative to cognitive rehabilitation for individuals with an acquired brain injury

194th Legislature (2025-2026) Introduced by James Arena-DeRosa and 23 co-sponsors

Requires Massachusetts health insurers to cover cognitive rehabilitation for acquired brain injury without unreasonable limitations on treatment duration or frequency.

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Bill Summary · HD 866

Legislative bill overview

HD 866 establishes requirements for health insurance coverage of cognitive rehabilitation services for individuals with acquired brain injuries in Massachusetts. The bill mandates that insurers cover medically necessary cognitive rehabilitation treatments without unreasonable limitations on duration or frequency of care.

Why is this important

Acquired brain injuries—from traumatic accidents, strokes, or other causes—often result in cognitive impairments affecting memory, attention, and executive function. Without adequate rehabilitation coverage, patients may lack access to specialized therapy that can significantly improve functional recovery and quality of life, placing financial burden on families and potentially increasing long-term disability costs.

Potential points of contention

  • Cost implications: Insurers and employers may argue that mandated coverage without specified limits increases premiums and healthcare costs, though proponents counter that early rehabilitation reduces overall medical expenses
  • Medical necessity standards: Disagreement over what constitutes "medically necessary" cognitive rehabilitation and who determines appropriate treatment duration and intensity (treating physicians vs. insurers)
  • Definition scope: Questions about which brain injuries qualify (traumatic vs. non-traumatic, specific severity thresholds) and whether coverage extends to progressive neurological conditions beyond initial acquired injuries

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

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