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Bill

S 896

Relates to the establishment of local comprehensive emergency management plans

2025 Regular Session Introduced by Monica Martinez and 2 co-sponsors

Prohibits health care providers from negotiating rate increases with carriers that exceed state health care cost growth benchmark, reshaping payer-provider contracts and access.

REFERRED TO GOVERNMENTAL OPERATIONS
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Bill Summary · S 896

Summary — S.896 (2025): An Act to prohibit inappropriate use of the health care cost growth benchmark

Purpose / intent

This bill would add a new restriction to Massachusetts insurance law intended to prevent health care providers from securing rate increases from carriers that exceed the State’s health care cost growth benchmark. The stated aim is to prohibit what the bill describes as “inappropriate use” of the benchmark to justify provider rate increases above the benchmark.

Key provision

  • Amends Section 9A of Chapter 176O of the General Laws by inserting a new clause (f) that:
    • “limits the ability of the health care provider to negotiate a rate increase with a carrier that exceeds the health care cost growth benchmark as established in Chapter 6D of section 9 of the general laws.”
  • The bill text is short and adds only this single clause; it does not specify enforcement mechanisms, exceptions, penalties, or implementation details.

Who would be affected

  • Health care providers (hospitals, physician groups, other provider entities): would face a legal limit on negotiating contractual rate increases that exceed the State’s health care cost growth benchmark.
  • Health insurers/carriers: would be constrained from entering provider contracts with rate increases above the benchmark (or at least be discouraged from doing so).
  • Patients and employers: could be indirectly affected if provider revenue, access, or contract negotiations change in response (potential impacts on availability of services, provider participation in networks, or insurer premiums).
  • State agencies responsible for the benchmark (statutorily established under Chapter 6D, e.g., Health Policy Commission) may play an implicit role in interpreting or enforcing the limit.

Procedural status and timeline (selected)

  • Introduced: 2025-03-06 (Senate) — presented by Senator Michael O. Moore (Second Worcester).
  • Committee referrals noted to multiple committees (Veterans, Homeland Security and Military Affairs; Health Care Financing; Environment and Public Works; Governmental Operations).
  • Passed Senate: 2025-05-21; Delivered to House/Assembly: 2025-05-21.
  • Hearing scheduled: 2025-06-02 (Gardner Auditorium).
  • Current status (per docket): Referred to Governmental Operations.

Related and sponsor information

  • Presented by: Michael O. Moore (per bill docket).
  • Additional sponsor listings provided in the docket: John Curtis, John W. Hickenlooper, Monica Martinez (as shown in provided materials).
  • Related/companion bills: SD 78 (replaces), S 8942 (prior session), A 6388 (companion).

Notes and uncertainties

  • The bill’s single-sentence insertion is broad and terse. It does not define how the limit would be measured, what constitutes “negotiation” versus other compensation, whether exceptions (e.g., new technologies, emergency services) apply, or which agency would enforce it.
  • Implementation would likely require regulatory clarification or further statutory detail to address contract law interactions, dispute resolution, and potential impacts on provider networks and patient access.

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

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