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Bill

S 695

Relates to authorizing small business tax-deferred savings accounts

2025 Regular Session Introduced by Patrick Gallivan

Requires health plans to reimburse licensed athletic trainers for covered services when referred by a physician, equal to reimbursement for similar providers to boost access.

REFERRED TO BUDGET AND REVENUE
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Bill Summary · S 695

Summary of S.695: An Act promoting consumer choice in health care

Overview

S.695, titled An Act promoting consumer choice in health care, seeks to expand health insurer reimbursement parity for licensed athletic trainers (ATs) when a physician refers a patient to services within the AT’s lawful scope of practice. The measure adds new protections to ensure these services are treated comparably to similar services provided by other health care providers, within the framework of existing insurance plan rules.

Purpose and intent

  • To ensure that, when a physician refers a patient to a licensed athletic trainer for covered services, the health insurer will reimburse the AT’s services if the insurer would reimburse another provider for the same services.
  • To promote consumer choice and access to athletic trainer care by reducing potential reimbursement-based barriers.
  • To align AT services with the general terms and utilization review practices applicable to other providers, while preventing discriminatory or overly restrictive administration of such care.

Key provisions

  • New statute: Section 226 added to Chapter 175 of the General Laws.
  • Reimbursement parity: A licensed athletic trainer, acting within the scope of practice and with physician referral, shall not be denied reimbursement by a health insurer for covered services if the insurer would reimburse another health care provider for those services.
  • Applicability: This section applies to health plans that provide coverage for a particular health service or for a medical condition within the AT scope of practice.
  • Cost-sharing and utilization controls: AT-provided services may be subject to reasonable deductibles, copayments, coinsurance, fee or benefit limits, practice parameters, and utilization review consistent with Division of Insurance rules.
  • Non-discrimination and scope: Reimbursement limits and reviews must not function to unfairly discriminate against AT care and must be no more restrictive than those for comparable care from other providers.
  • Continuation of rights: Nothing in the section shall impede or prevent the provision or coverage of health care services by licensed athletic trainers within their lawful scope.
  • Definitions: “Health insurance plan” encompasses individual or group policies, hospital or medical service corporations, or other health benefit plans offered by a health insurer. The term excludes benefit plans providing coverage for a specific disease or other limited benefit coverage.

Who is affected

  • Licensed athletic trainers: Potentially broadened access to reimbursement when referred by physicians.
  • Health insurers and health plans: Subject to parity requirements and any associated utilization review rules.
  • Patients: May experience improved access to AT services and more uniform coverage for AT-provided care.
  • Physicians and other health care providers: Affected indirectly through referral patterns and insurer reimbursement processes.

Legislative history and status

  • Introduced: February 24, 2025.
  • Docket/Committee actions: Read twice and referred to the Committee on Finance; also referred to the Financial Services committee on February 27, 2025.
  • House action: House concurred on February 27, 2025.
  • Hearing: Scheduled for September 17, 2025, from 12:30 PM to 4:30 PM in Gardner Auditorium.
  • Related: Similar matter filed previously (Senate No. 603 of 2023-2024); companion HR 1199; SD 1352 replaces.
  • Sponsors: Listed sponsor in the bill materials is Brendan P. Crighton (petitioning sponsor) with Marcus S. Vaughn; the sponsors section lists John Cornyn as primary, which appears inconsistent with the Massachusetts context in this document.

Timeline and next steps

  • Hearing: 09/17/2025 (Gardner Auditorium) — key for testimony and discussion.
  • Post-hearing: Committee deliberations on the bill’s merits, potential amendments, and eventual floor votes in the Senate and House.
  • If advanced, the bill would proceed toward final passage and potential enrollment as law, subject to approval by both chambers and the governor.

Fiscal and policy considerations

  • The provided material does not include a stated fiscal impact.
  • Policy questions may include: the administrative burden of implementing parity, how reviews under Division of Insurance rules will be harmonized with AT practice parameters, and any potential premium or cost impacts on plans that cover athletic trainer services.

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

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