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S 746

Relates to the safe storage of firearms and child access prevention; repealer

2025 Regular Session Introduced by Shelley Mayer

Mandates 3-business-day prior authorization validity for NEMT and sets a 2.5× payment floor for key MassHealth NEMT codes to boost access and fund providers (plus a study).

SUBSTITUTED BY A814
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Bill Summary · S 746

Summary — S 746 (An Act to improve patient access to non‑emergency medical transportation)

Note: The header title in the provided materials (referring to firearm storage) appears to be an error. The bill text and docket indicate S 746 addresses non‑emergency medical transportation (NEMT).

Purpose

To improve patient access to non‑emergency ambulance and wheelchair‑van transportation for specified clinical services by (1) requiring minimum prior‑authorization validity periods and (2) increasing minimum reimbursement levels for certain NEMT services (for Medicaid/contracted plans). It also directs a study of reimbursement adequacy and workforce impacts for NEMT providers.

Key provisions

  • Prior authorization validity (across multiple statutes):
    • Adds language to several chapters of the Massachusetts General Laws (G.L. c.32A; c.118E; c.175; c.176A; c.176B; c.176G) requiring that, when a prior authorization is required for non‑emergency ambulance or wheelchair‑van transport to the following types of care, the authorization must be valid for at least 3 business days:
    • Inpatient and outpatient dialysis treatment
    • Inpatient and outpatient behavioral health services
    • Inpatient and outpatient post‑acute care
  • Increased reimbursement for Medicaid/contracted plans (G.L. c.118E, new §83):
    • The division (MassHealth) and its contracted insurers/plans/behavioral health managers/third‑party administrators must pay eligible and nonpublic ambulance providers no less than 2.5 times the “determined rates” for the following HCPCS/CPT codes when transporting covered members to the specified services:
    • A0426 — Ambulance service, advanced life support, nonemergency transport
    • A0428 — Ambulance service, basic life support, nonemergency transport
    • A0130 — Nonemergency wheelchair van transportation
    • S0215 — Nonemergency wheelchair transport with loaded mileage
    • T2001 — Nonemergency wheelchair transport with patient attendant/escort
    • Any required prior authorization for these services must also be valid for at least 3 business days.
    • Executive office directed to promulgate regulations to implement this section.
  • Study (Section 7):
    • Health Policy Commission (with Center for Information and Analysis) to study adequacy of MassHealth and commercial reimbursement rates for NEMT, including external economic factors affecting EMS workforce sustainability (e.g., minimum wage increases, competition).

Who is affected

  • Patients needing transportation to dialysis, behavioral health, and post‑acute services (potentially fewer denials/delays due to longer prior‑auth windows).
  • NEMT providers (ambulance services, wheelchair‑van operators, including nonpublic providers) — potential for higher reimbursements under affected Medicaid/contracted plans.
  • MassHealth, Medicaid managed care organizations, contracted insurers, HMOs, and other payers (increased payment obligations under c.118E provision; regulatory changes may follow).
  • State agencies (Executive Office, Health Policy Commission) tasked with rulemaking and study.

Fiscal and operational implications

  • The 2.5× floor on reimbursement for listed codes, if applied broadly to MassHealth/contracted plans, could materially increase program and payer expenditure for NEMT trips; fiscal impact would depend on trip volumes and whether the requirement applies only to certain managed‑care contracts or wider payment streams.
  • A 3 business‑day minimum prior‑authorization window may reduce administrative churn and missed trips but could require process changes by payers and providers.
  • The mandated study will inform future policy around rate setting and workforce supports.

Procedural status / timeline (as provided)

  • Filed in Senate docket: 1/17/2025
  • Introduced in Senate / Read twice and referred: 2/26/2025
  • Legislative record indicates the bill was SUBSTITUTED BY A814 (listed 2/03/2025) — status: SUBSTITUTED BY A814.
  • Hearing scheduled (per record): 10/27/2025 (Gardner Auditorium)
  • Sponsors listed: Jim Banks (primary) and Shelley Mayer (primary)
  • Related legislation: A 814 (companion), HR 1595 (companion), SD 2233 (replaces)

Note: Some dates in the provided legislative actions appear inconsistent (e.g., substitution dated before introduction). Consult the official Massachusetts legislative website/docket for the authoritative current status and text (especially to review A814, which reportedly substituted S 746).

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

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