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SD 1928

An Act relative to health insurance coverage notification

194th Legislature (2025-2026) Introduced by Jake Oliveira

Requires health insurers/plans to give patients at least 60 days advance notice before any change that increases ongoing out-of-pocket costs for care, prescriptions, or supplies.

House concurred
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Bill Summary · SD 1928

Summary: Senate Docket No. 1928 — An Act Relative to Health Insurance Coverage Notification

Overview

  • Bill Number: SD 1928
  • Title: An Act relative to health insurance coverage notification
  • Status: House concurred
  • Introduced: February 27, 2025
  • Committee Action: Referred to the Committee on Financial Services (same date as concurrence)
  • Classification: Proposed bill (Massachusetts, 194th General Court, 2025-2026)

Main purpose

The bill adds a requirement that patients be given advance notice before any change to ongoing medical costs that would increase their out-of-pocket costs for health care. The goal is to provide patients with time to prepare for and respond to higher financial obligations related to care, prescriptions, and medical supplies or other treatments.

Key provisions

  • Amendment target: Section 6 of Chapter 176O (as it currently appears in law).
  • Added requirement: After the words describing “denied enrollment,” the bill adds the following clause:
    • For any change to ongoing medical costs that will increase the out-of-pocket costs to the patient, including costs related to prescription drugs, medical supplies, or other treatment, a patient must be given at least a 60-day notice before those changes take effect.
  • Notice specifics: The text provided does not specify the method of notice, the responsible party (e.g., insurer, plan sponsor, or provider), or any exceptions to the rule. It simply requires a 60-day prior notice.

Who is affected

  • Primary beneficiaries: Patients who may face increased out-of-pocket costs for ongoing medical care, prescriptions, or related items.
  • Likely affected entities: Health insurers or health plans operating under Massachusetts law would be responsible for providing the mandated notice, although the bill text does not explicitly designate the notifier or the notification process.

Procedural and timeline aspects

  • Introduction: February 27, 2025.
  • House action: House concurred on February 27, 2025.
  • Next steps: Referred to the House Committee on Financial Services for consideration.
  • Effective date: The bill text provided does not specify an effective date or phase-in period.

Context and potential impact

  • Consumer protection: The bill enhances transparency by giving patients up to 60 days to adjust to higher out-of-pocket costs.
  • Administrative considerations: Insurers and plan sponsors would need to implement or modify notification processes to comply with the 60-day requirement.
  • Limitations: The text available does not define notification methods, carriers responsible, or any carve-outs (e.g., emergencies, small increases, or annual cap scenarios).

This summary captures the substantive proposal and its potential effects based on the provided bill text. If the full committee language becomes available, additional details such as notice format, methods, and any exemptions can be incorporated.

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

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