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S 683

Wiley Kennedy Foundation

2025-2026 Regular Session Introduced by Tameika Isaac Devine

Requires insurers to cover medically necessary IEP/IFSP services; districts may bill with parental consent, protect privacy, and limit family costs from private plan premiums.

Referred to Committee on Judiciary
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WeVote Research Nonpartisan
Bill Summary · S 683

Summary — S.683 (Print 683A): An Act relative to special education health care costs

Note: The bill file you provided includes text titled “An Act relative to special education health care costs.” (sponsor: Sen. Cynthia Stone Creem). This differs from the short one-line title in your metadata about a real‑property tax exemption for surviving spouses; this summary is based on the bill text in the packet (special education health care costs / insurer and school‑billing provisions).

Purpose and intent

The bill requires public and private health insurance plans to provide, on a nondiscriminatory basis, coverage for medically necessary treatments that a student’s Individualized Education Program (IEP), Individualized Family Service Plan (IFSP), or similar plan requires under the federal Individuals with Disabilities Education Act (IDEA). It also sets rules governing how school districts may request and use family insurance information, obtain consent to bill insurers for school‑provided services, protect families from being required to use private coverage when it would impose financial cost, and limit disclosure of student health/IEP information to insurers.

Key provisions

  • Amend Chapter 32A: The Group Insurance Commission (GIC) must provide benefits to active or retired Commonwealth employees insured under GIC for medically necessary treatments required by a student’s IEP/IFSP/ISP/IDEA requirements on a nondiscriminatory basis.
  • Add Section 47VV to Chapter 175: Individual and group accident & sickness policies that provide hospital/surgical coverage (issued or renewed in MA) must likewise provide benefits for medically necessary IEP/IFSP‑required treatments.
  • School district procedures for accessing health benefits:
    • Districts shall request, but may not require, families to provide information about the child’s private coverage when reimbursable services begin and may request updated information as needed.
    • Districts must obtain annual written informed consent from a parent/legal guardian before billing a health plan. The consent must notify families that:
    • billing may cause increases in private insurance premiums;
    • the district may pay certain enrollee health plan costs (co‑pays, coinsurance, deductibles, premium increases, other cost‑sharing) for IEP/IFSP services;
    • billing may affect plan service limits and prior authorization thresholds;
    • consent may be revoked in writing at any time.
    • Districts must inform families that refusal to allow billing does not relieve the district of its obligation to provide FAPE (free appropriate public education) at no cost to the parent.
  • Protections for families:
    • To the extent required by federal law, districts may not require parents to use private health coverage if doing so would create financial cost.
    • Districts may not deny, withhold, or delay required services because a family refuses consent to bill or because an insurer refuses payment.
  • Privacy and disclosure limits:
    • Districts may disclose IEP content, diagnosis, and treatment records to a health plan only with signed, dated parental consent and only the information necessary for coverage/payment decisions.
    • Health plans may use disclosed information only to make coverage/payment decisions and as otherwise permitted by law.

Who is affected

  • Primary: students with disabilities receiving IEP/IFSP/ISP‑mandated health‑related services, and their families.
  • Schools and school districts: administrative responsibilities for consent, billing, and handling insurer interactions; possible new billing and cost‑sharing payments.
  • Insurers: individual, group, and the Group Insurance Commission — obligations to cover medically necessary, education‑mandated services.
  • Potential fiscal stakeholders: district budgets (if districts pay enrollee cost‑sharing), insurers (increased claims), and possibly taxpayers if state GIC costs change.

Procedural status and timeline (highlights)

  • Filed: 1/14/2025 (Senate Docket 631 / Senate No. 683).
  • Introduced/Read twice and referred to Committee on Finance: 2/24/2025.
  • Referred to other committees earlier in process (Local Government, Ways & Means appears in docket history).
  • Passed Senate: 6/06/2025; delivered to House/Assembly and passed the Assembly: 6/10/2025; returned to Senate: 6/10/2025. Current status listed as RETURNED TO SENATE.
  • Hearing scheduled: 10/08/2025 (Gardner Auditorium).
  • Print number: 683A. Also noted as a substitute for A3729 in the legislative history.

Potential implications

  • May shift some costs for school‑based, IEP‑required services to insurers and/or trigger increased insurer payments and administrative claims processing.
  • Could cause private plan premium or cost‑sharing impacts for families (the bill requires disclosure of that possibility and allows districts to pay certain enrollee costs).
  • Strengthens parental protections consistent with federal IDEA rules by forbidding denial of services when families refuse billing consent or insurers refuse payment.
  • Administrative burden on districts to obtain annual consent, manage billing, and safeguard health/IEP data.

If you want, I can:
- Extract the exact text of each new statutory subsection for quick reference;
- Produce a one‑page fiscal/operational impact checklist for school districts and insurers.

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

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