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H 1172

An Act relative to insurance coverage for new treatment

194th Legislature (2025-2026) Introduced by John Gaskey

Massachusetts bill requiring insurance coverage for new medical treatments, balancing patient access against insurer costs through potential coverage mandates.

Hearing scheduled for 10/08/2025 from 10:30 AM-02:30 PM in Gardner Auditorium
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Bill Summary · H 1172

Legislative bill overview

H 1172 is a Massachusetts bill that addresses insurance coverage requirements for new medical treatments. While specific details about which treatments or coverage standards are being mandated are not provided in the available legislative record, the bill appears to establish or modify insurance company obligations regarding newly approved therapeutic options. The bill has progressed through initial legislative stages and is scheduled for a hearing in October 2025.

Why is this important

Insurance coverage decisions directly affect patient access to medical innovations and out-of-pocket costs for residents. The outcome of this bill could determine whether insurance companies must cover emerging treatments, potentially impacting treatment accessibility and healthcare affordability across Massachusetts. This type of legislation often becomes a model for other states considering similar insurance reform.

Potential points of contention

  • Treatment definition and approval standards: Disagreement may exist over which "new treatments" qualify for mandatory coverage (FDA-approved only, or experimental treatments as well)
  • Insurance company costs vs. patient access: Insurers may argue coverage mandates increase premiums, while patient advocates contend barriers deny access to potentially life-saving options
  • Coverage timeline and evidence requirements: Questions about how quickly insurers must cover new treatments and what evidence of efficacy is required before coverage becomes mandatory

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

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