Malden Delegation Applauds Passage of Healthcare Quality Oversight Bill

BOSTON (January 22, 2025) —State Senator Jason Lewis and State Representatives Paul Donato, Steve Ultrino, and Kate Lipper-Garabedian joined their colleagues in the Massachusetts Legislature to pass urgent reforms to the Commonwealth’s healthcare system to boost oversight and transparency in the market and improve patient access to quality, affordable treatment.

This new law closes loopholes in the healthcare market regulatory process exposed by the collapse of Steward Health Care, increases financial transparency of hospitals and other providers, and will help ensure a more stable and sustainable healthcare system in Massachusetts.

“Access to high-quality, affordable healthcare should be a basic human right, but unfortunately some healthcare providers like Steward have put profits ahead of patients and engaged in greed and mismanagement,” said State Senator Jason Lewis. “The reforms contained in this important legislation will help prevent this from happening again, thereby protecting patients and access to care.”

“With the passage of the Healthcare Quality Oversight Bill, we ensure that every Massachusetts resident has access to high quality, patient-centered care,” said State Representative Paul Donato. “This bill will strengthen transparency and accountability in the healthcare sector. I am proud to have been part of this effort.”

“With the passage of this bill, we are pushing in a new era of accountability and transparency in our healthcare system,” said State Representative Steven Ultrino. “This is a crucial step in putting patients first and reaffirming our commitment to patient safety and quality healthcare.”

“Provisions of this legislation include reforms to improve the long-term sustainability of vital community health centers like Melrose Wakefield Hospital, which serves as a bedrock in the 32nd Middlesex District,” said State Representative Kate Lipper-Garabedian. “The bill further takes important steps toward transparency, accountability, and accessibility regarding the provision of care at our hospitals and health care facilities across the Commonwealth.”

Key provisions of this legislation include:

● Expanding state oversight of hospitals and registered provider organizations (RPOs), including significant private equity investors.

● Increasing penalties for not complying with data reporting requirements.

● Requiring the Department of Public Health (DPH) to hold a public hearing prior to any hospital or essential health service closure, and authorizing DPH to seek an impact analysis of a hospital or essential service closure.

● Expanding the Attorney General’s authority to monitor healthcare trends and enforce the False Claims Act by allowing her office to seek information from significant equity investors, real estate investment trusts (REITs), and management services organizations (MSOs), and to hold entities with an ownership or controlling interest in a provider organization liable if they are aware of false claims submitted to the government.

● Ensuring adequate warning before medical equipment can be repossessed.

● Increasing financial transparency by expanding the authority of state agencies to monitor hospital financial conditions, including investments and information on any relationships with significant private equity investors, healthcare REITs, and MSOs.

● Expanding the scope of the annual healthcare cost trends hearings held by the Health Policy Commission (HPC).

● Establishing a new Office of Health Resource Planning within the HPC to produce a state health plan with a forecast of anticipated demand, supply, and distribution of healthcare resources on a statewide and regional basis.

● Improving access to primary care by establishing a task force to study and make recommendations for improving primary care access, delivery, and financial stability.

After final passage in the House of Representatives and Senate, Governor Maura Healey signed the bill into law on January 8, 2025.

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Press Contact:

Hannah Li

Office of State Representative Steve Ultrino

Hannah.Li@MAHouse.gov

Malden Delegation Supports Passage of Bill to Lower Prescription Drug Costs

BOSTON (January 14, 2025) —State Senator Jason Lewis and State Representatives Paul Donato, Steve Ultrino, and Kate Lipper-Garabedian joined their colleagues in the Massachusetts Legislature to pass comprehensive reforms to lower the cost of prescription drugs at the pharmacy counter and improve oversight of the state’s pharmaceutical industry.

An Act relative to pharmaceutical access, costs, and transparency takes bold action to lower or eliminate out-of-pocket costs and ensure access to life-saving medications by requiring health insurers to offer price relief for prescription drugs used to treat diabetes, asthma, and certain heart conditions. This bill further brings down costs by ensuring that consumers are not charged a cost-sharing amount, such as a co-pay, if it would be cheaper for them to purchase the drug without using their insurance. Approximately 9% of Massachusetts residents have diagnosed diabetes; 6% of adults over 35 have heart disease; and more than 10% of residents live with asthma. This bill is particularly critical for residents of color, who disproportionately face chronic illnesses. Over 12% of Black residents live with diabetes and nearly 14% of Black adults live with asthma.

“Working to expand access to quality, affordable healthcare has always been one of my top priorities in the legislature,” said State Senator Jason Lewis. “I’m proud to support this critical legislation that makes life-saving drugs more affordable and accessible for patients, and holds pharmaceutical companies, insurers, and pharmacy benefit managers more accountable for their actions.”

“This legislation marks Massachusetts as a leader in addressing the rising costs of prescription medications,” said State Representative Paul Donato. “This bill emphasizes greater transparency in pricing and allows consumers to make informed decisions regarding their healthcare. It also shows the legislature’s continued commitment to reducing costs and improving the quality of healthcare in the Commonwealth.”

“With this legislation, we take a significant step forward in making healthcare more accessible to all. By passing this bill to lower prescription drug costs, we are ensuring that no one has to sacrifice their health due to unaffordable medications,“ said State Representative Steven Ultrino. “This is a win for all who have felt the strain of rising drug prices. We will continue to work to create a healthcare system that prioritizes the well-being of our communities.”

“Too often, patients are forced to pay exorbitant costs for prescription drug medications,” said State Representative Kate Lipper-Garabedian. “I was proud to join my colleagues to support this legislation to reduce copays, cover generic drug prescription costs, and ensure increased oversight and regulations of Pharmacy Benefit Managers. This bill furthers the Commonwealth’s commitment to ensuring healthcare is affordable, accessible, and equitable for all of our residents.”

Key provisions of this legislation include:

● Lowering consumer prescription drug costs for diabetes, asthma, and certain heart conditions by requiring insurers to eliminate cost-sharing requirements for one generic drug and to cap co-payments on one brand-name drug at $25 per 30-day supply.

● Increasing oversight of pharmacy benefit managers (PBMs) by authorizing the state Division of Insurance to license and regulate PBMs, which play a major role in determining how prescription drugs are tiered and priced on insurance plans.

● Establishing the Office for Pharmaceutical Policy and Analysis within the Health Policy Commission (HPC) to analyze trends and publish an annual report with recommendations for strategies to promote affordability, enhance medication access, and mitigate pharmaceutical spending growth.

● Requiring pharmaceutical manufacturers and PBMs to provide public testimony on the factors that influence drug costs and allowing these factors to be taken into account by the HPC to identify how to improve care and reduce costs for patients.

After final passage in both the House and Representatives and the Senate, Governor Maura Healey signed the bill into law on January 8, 2025.

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Press Contact:

Hannah Li

Office of State Representative Steve Ultrino

Hannah.Li@MAHouse.gov

Malden Delegation Helps Pass Bill to Combat Substance Use Disorder

BOSTON (January 8, 2024) —State Senator Jason Lewis and State Representatives Paul Donato, Steve Ultrino, and Kate Lipper-Garabedian joined their colleagues in the Massachusetts Legislature to pass legislation that will combat the opioid crisis and support residents living with substance use disorder (SUD).

An Act relative to treatments and coverage for substance use disorder and recovery coach licensure expands non-opioid pain treatments, establishes licensing for recovery coaches, and supports pregnant women and their children who have been exposed to substances.

It will greatly expand access to opioid-reversal drugs like naloxone. In 2023, 2,125 lives were lost as a result of an overdose, 232 fewer than in 2022, according to the Department of Public Health (DPH). Since 2023, naloxone has reversed more than 10,000 overdoses in Massachusetts.

“The devastating impacts of substance use disorder cause immeasurable pain to families, friends, and neighbors in our communities, especially for those who have lost loved ones,” said State Senator Jason Lewis. “This new law will help more people along their journey to recovery and save many lives.”

“This recovery bill represents a monumental step in ensuring that people with substance use disorders have access to comprehensive treatment and recovery support,” said State Representative Paul Donato. “By establishing licensure for recovery coaches, we are certifying a workforce to assist individuals on their path towards recovery.”

“This law is a powerful step forward in our fight against the opioid crisis,” said State Representative Steven Ultrino. “By expanding access to treatment, supporting recovery, and providing the resources necessary for long-term success, we are giving individuals the opportunity to reclaim their lives and rebuild stronger, healthier communities for all. "

“I was glad to join the Legislature to enact this timely piece of legislation to address our state's ongoing opioid epidemic,” said State Representative Lipper-Garabedian. “Too many families have lost loved ones to addiction. With critical provisions aimed at expanding access to resources like reversal drugs and recovery coaches and protections for our public health and harm reduction workers, this bill will save lives.”

Key provisions of the legislation include:

● Mandating that all health insurance plans cover opioid reversal drugs such as naloxone and Narcan—without cost-sharing or prior authorization.

● Educating patients with a history of opioid use about reversal drugs by requiring hospitals and substance use treatment facilities to teach patients about opioid reversal drugs and to prescribe or dispense at least two doses to at-risk patients upon discharge.

● Requiring pharmacies to maintain a sufficient supply of opioid reversal drugs in areas with high incidences of overdoses.

● Establishing recovery coach licensure under the DPH and requiring health insurance plans to cover recovery coach services.

● Expanding access to non-opioid pain treatments by incorporating non-opioid alternatives into provider training and updating insurance provider requirements to ensure inclusion of non-opioid treatments.

● Boosting anti-discrimination protections for people with SUD by clarifying DPH’s authority to enforce anti-discrimination protections and prohibiting discrimination against those lawfully possessing or taking medication for opioid-related SUD treatment.

● Promoting the recovery of pregnant women on medications for substance use disorder by clarifying that encountering a substance-exposed newborn does not trigger an automatic referral to the Department of Children and Families, and directing the department to lead the creation of regulations related to care, treatment, and reporting of substance-exposed newborns.

● Protecting public health and harm reduction organizations from professional disciplinary action or civil or criminal liability if they are providing drug checking services in good faith, and shielding individuals from criminal liability when seeking treatment from such organizations to help detect and protect against deadly contaminants that are increasingly found in the drug supply.

● Prohibiting life insurance companies from limiting or refusing coverage to a person solely because they obtained an opioid-reversal drug, and restricting medical malpractice insurers from discriminating against health care practitioners who provide harm reduction services. After final passage in both the House of Representatives and the Senate, Governor Maura Healey signed the bill into law on December 23, 2024.

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Press Contact:

Hannah Li

Office of State Representative Steve Ultrino

Hannah.Li@MAHouse.gov