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H 2378

An Act to increase patient access to certain health care services

194th Legislature (2025-2026) Introduced by Nick Boldyga

Mass. H 2378 creates criteria for when hospital/service changes trigger regulatory review, aiming to expand patient access and clarify what counts as new technology.

Accompanied a study order, see H5330 (under House Rule 27)
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Bill Summary · H 2378

Summary of H 2378: An Act to increase patient access to certain health care services

Overview

  • Sponsor: Rep. Nicholas A. Boldyga (3rd Hampden)
  • Introduced: February 27, 2025
  • Committee: Referred to the Public Health Committee (as of 2025-02-27)
  • Status / Hearing: Hearing originally scheduled; updated to be held on September 29, 2025 (A-2) with a virtual option and a new end time. Multiple notices list the same rescheduling details.
  • Context: The bill aims to adjust how Massachusetts categorizes health care facilities, what constitutes “new technology,” and when a facility must seek approval for substantial changes in services. It aligns with prior related efforts (similar measures filed in 2023-24).

Purpose and intent

  • To expand or clarify patient access to health care services by refining definitions and regulatory thresholds governing the expansion, addition, or alteration of health care services at various facilities.
  • To establish criteria for when a change in services constitutes a “substantial change in services” requiring regulatory review and potential approval.
  • To distinguish between traditional medical facilities and other entities (e.g., those focused solely on spiritual healing) for regulatory purposes.

Key provisions and changes

Definitions

  • “Health care facility” (Section 25B, ch. 111): Broadly includes hospitals, clinics, long-term care facilities, convalescent or nursing homes, rest homes, charitable homes for the aged, clinical laboratories, public medical institutions, and certain publicly funded institutions for the developmentally disabled or mentally ill that participate in federal programs administered under Titles 18 and 19 of the Social Security Act. Excludes facilities operated by religious groups that do not provide medical care and ambulatory surgical centers.
  • “New technology”: Equipment or services deemed new by the department for reasons of quality, access, or cost; exceptions include CT scanners and widely established diagnostic/therapeutic technologies; air ambulance services are explicitly excluded as “new technology.”

Substantial change in services

  • The bill specifies when changes to services constitute a substantive change that triggers regulatory review. It distinguishes between:
    • Acute-care hospitals and non-acute facilities.
    • For acute-care hospitals:
    • (1)(a) Addition/expansion/conversion to an innovative service (regardless of expenditure minimum).
    • (1)(b) Addition/expansion or conversion to services that non-acute facilities could provide.
    • Exception: conversions to skilled nursing, rehabilitation, acute psychiatric, or substance abuse services in underbedded areas require criteria and written certification; regulations to define criteria and reconversion are to be promulgated.
    • For non-acute facilities:
    • (a) Addition of a service with annual operating costs exceeding the expenditure minimum.
    • (b) Increase in bed capacity by more than 12 beds.
    • (c) Addition/expansion/conversion to an innovative service (regardless of minimum).
    • (d) Decreases in service level at nursing/convalescent/rest homes not involving capital expenditure above $800,000 are exempt from Sections 25C–25G.
    • (e) An increase in staff alone does not count as substantial change unless it leads to operating costs exceeding the minimum.
    • Outpatient services purely related to outpatient care (excluding ambulatory surgery) that are not defined as innovative do not constitute a substantial change.

Who is affected

  • Hospitals and health care facilities (acute-care and non-acute) will be subject to new thresholds to determine whether service changes require regulatory review and potential approval.
  • Public health regulators (Department) will define, regulate, and administer the criteria for “new technology” and “substantial change,” including underbedded areas and reconversion rules.
  • Patients may gain greater access where facilities are allowed to implement certain new technologies or services without triggering additional regulatory hurdles, depending on how the criteria are applied and exemptions invoked.

Procedural and timeline aspects

  • The bill was introduced on February 27, 2025 and referred to the Public Health Committee.
  • Legislative actions show multiple updates to the hearing schedule, with the latest notice setting the hearing for September 29, 2025 (A-2) and a virtual session with an updated end time.
  • Related historical context: similar language appeared in a 2023-2024 filing (House No. 2139). Related bill HD 3511 is noted as a replacement in the related filings.

Notes

  • The bill seeks to balance expanded patient access with regulatory oversight by calibrating what constitutes a “substantial change” and by clarifying what counts as “new technology” in health care settings.
  • Exact fiscal impact, implementation timelines, and regulatory rulemaking details would emerge through committee process and subsequent regulatory updates.

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

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