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H 1394

An Act relative to family members serving as caregivers

194th Legislature (2025-2026) Introduced by Jim Arciero and 47 co-sponsors

MassHealth HCBS payments expanded to legally liable family members (parents, guardians, adult children) as paid caregivers, via a state plan amendment/waiver.

Reporting date extended to Friday, July 31, 2026
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Bill Summary · H 1394

Summary of H.1394 — An Act relative to family members serving as caregivers

Purpose and intent

H.1394 expands the set of individuals who can be paid by MassHealth to serve as home- and community-based caregivers under MassHealth-funded programs. Specifically, it adds legally liable family members to the definition of “family member” for MassHealth caregiver payments, thereby increasing options for in-home care within MassHealth-supported services.

Key provisions

  • Amends Section 12 of Chapter 118E of the General Laws (as appearing in the 2022 Official Edition).
  • Adds, after the existing language, that in MassHealth-funded home- and community-based services programs, legally liable family members may serve as paid caregivers. Legally liable family members include:
    • Biological, adoptive, foster, or step-parents
    • Legal guardians
    • Powers of attorney and healthcare powers of attorney
    • Adult children of the care recipient
  • Requires the Executive Office of Health and Human Services (EOHHS) to file a state plan amendment or waiver application as needed to permit these legally liable family members to be paid caregivers under MassHealth.
  • The amendment operates “notwithstanding” any contrary laws, ensuring the change can proceed through the plan/waiver process.

Affected parties

  • Care recipients enrolled in MassHealth home- and community-based services programs that pay family members as caregivers.
  • Legally liable family members who wish to be paid as formal caregivers (e.g., parents, guardians, adult children with caregiving responsibilities).
  • MassHealth and EOHHS, which would implement the plan amendment/waiver and oversee program compliance.

Implementation and timeline

  • Implementation hinges on obtaining any required federal/state plan amendments or waivers and subsequent program changes.
  • Legislative actions in the docket indicate ongoing committee consideration and scheduling:
    • Referred to the Committee on Health Care Financing (Feb 27, 2025)
    • Hearing scheduled (July 1, 2025)
    • Senate concurrence noted
  • Status update: Reporting date extended to Wednesday, March 18, 2026 (extension to allow additional review and action).

Practical impact and considerations

  • Potentially expands access to in-home caregiving by allowing legally liable family members to be compensated, which may improve continuity of care and stability for care recipients.
  • Could have fiscal implications for MassHealth in terms of staffing, reimbursement rates, and administration; a state plan amendment/waiver process will determine federal Medicaid alignment and funding.
  • The bill does not specify caregiver wages, eligibility criteria beyond “legally liable family member,” or programmatic safeguards, which are typically addressed in the state plan amendment and related regulations.

Background

  • Sponsored by Rep. James J. O’Day and a broad slate of co-sponsors.
  • House Docket: 1110; Bill number: 1394; Introduced February 27, 2025.
  • Related actions and status updates reflect ongoing consideration in the 2025-2026 General Court.

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

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