MA H1358

Requires the Division of Medical Assistance and Health Policy Commission to ensure all research used for healthcare coverage decisions meets patient-centeredness standards, including outcomes prioritized by patients and people with disabilities

Prohibits both agencies from using quality-adjusted life year (QALY) metrics or similar measures to determine treatment cost-effectiveness, coverage, reimbursement, or payment policies

Mandates consideration of patient subgroups to account for differences in preferences and clinical characteristics within patient subpopulations

Requires research to comply with scientific rigor standards, including consideration of real-world evidence and peer-reviewed studies, while avoiding over-interpretation of "inconclusive" findings

Requires all policies limiting patient access to include appeals or physician override mechanisms, with protections against discrimination for physicians who use these overrides