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S 791

Relates to the Alex R. Jimenez New York state military immigrant family legacy program

2025 Regular Session Introduced by Nathalia Fernández

Allows licensed professionals to prescribe or refer outdoor time as treatment and requires MassHealth and private insurers to cover nature-based care.

SUBSTITUTED BY A2435
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Bill Summary · S 791

Summary — S.791 (2025) — "An Act relative to nature as a prescription"

Note: The bill text provided is a Massachusetts bill introduced by State Senator Liz Miranda (Senate Docket No. 1631 / Senate No. 791) titled “An Act relative to nature as a prescription.” The metadata includes some inconsistent items (references to other jurisdictions and federal sponsors). This summary focuses on the substantive provisions in the bill text.

Purpose and intent

Establish a statutory framework to allow licensed health professionals and social service providers to prescribe or refer “accessing nature” (outdoor time, nature‑based activities) as a form of medical treatment, mental health treatment, or social rehabilitation — and to require public and private payers to cover those services when prescribed or referred.

Key provisions and changes

  • Adds a new section to Chapter 32A (state employee group insurance):

    • Requires the Group Insurance Commission to provide coverage for nature‑based treatment for active and retired state employees when prescribed or referred under the new Chapter 112 provisions (see below).

  • Adds three new sections to Chapter 112:

    • Section 42E — Permits prescribers authorized under chapter 94C (controlled substances) to prescribe outdoor time/accessing nature when acting in good faith as part of professional practice for alleviation of pain, suffering, or disease.
    • Section 42F — Permits licensed mental health providers to prescribe outdoor time/accessing nature for treatment of mental health symptoms.
    • Section 42G — Permits social service providers working with people experiencing social or emotional trauma (job loss, divorce, food insecurity, immigration issues, probation, etc.) to refer clients to outdoor time/accessing nature for social rehabilitation.

  • Amends multiple insurance statutes to require coverage:

    • Chapter 118E (MassHealth) — Division and contracted Medicaid plans, MCOs, behavioral health firms, and third‑party administrators must cover nature‑based services prescribed/referred under 42E–42G.
    • Chapter 175, 176A, 176B, 176G (private accident/sickness, hospital service plans, medical/mental health service agreements, HMOs) — Individual and group policies issued or renewed in the Commonwealth must provide coverage for prescribed/referred nature‑based treatments.

  • Chapter 132A (state parks/conservation) amendment:

    • Commissioner must waive all fees (including parking and special privileges) for individuals enrolled in MassHealth.

  • Interagency review and equity requirement:

    • DPH and DCR commissioners to jointly review existing programs and budgets to identify collaboration opportunities to develop/implement outdoor/environmental/agricultural therapeutic programs; review includes equitable access and strategies to ensure BIPOC, environmental justice and underrepresented communities feel safe and welcome. (Text truncated in provided version; further implementation details not shown.)

Who is affected

  • Patients/clients: Medicaid/MassHealth enrollees, privately insured individuals, state employees and retirees, and clients of social service and mental health providers who may receive nature prescriptions/referrals.
  • Providers: Licensed prescribers (as defined), mental health clinicians, social service professionals.
  • Payers: MassHealth, Medicaid managed care plans, private insurers, HMOs, behavioral health management firms, third‑party administrators, and the Group Insurance Commission.
  • State agencies: Department of Public Health (DPH), Department of Conservation and Recreation (DCR), Group Insurance Commission.

Procedural status / timeline (from provided actions)

  • Filed: January 16, 2025 (Senate Docket No. 1631 / Senate No. 791)
  • Introduced / Read twice and referred: February 27, 2025 (committees: Energy & Natural Resources; Financial Services)
  • Hearing scheduled: October 8, 2025 (Gardner Auditorium)
  • Listed as “SUBSTITUTED BY A2435” in records (indicates a House companion/substitute bill A2435—check current legislative records to confirm final status and text).

Potential impacts and implementation considerations

  • Expands recognized treatment modalities to include nature‑based interventions and obligates payers to cover prescribed/referral services, which could increase utilization and require new benefit definitions, billing codes, and provider guidance.
  • Administrative implementation: insurers and state agencies will need policies, coverage criteria, and provider standards; DPH/DCR review may identify pilot programs or funding reallocations.
  • Equity and access focus: the bill directs agencies to consider barriers for BIPOC and underrepresented communities, and waives certain park fees for MassHealth enrollees to reduce financial barriers.

For the latest status and any amendments or the full substituted text (A2435), consult the Massachusetts General Court legislative website.

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

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