MA H4342

Requires health insurers to cover medically appropriate evaluation and management services in outpatient settings (including office and hospital-based clinics) without charging a deductible

Applies to multiple types of insurance plans including state employee health plans (Chapter 32A), municipal employee plans (Chapter 32B), commercial insurers (Chapter 175), Blue Cross Blue Shield plans (Chapters 176A and 176B), and HMOs (Chapter 176G)

Division of Insurance will develop guidelines defining which evaluation and management services qualify for deductible-free coverage

Exempts plans governed by Federal Internal Revenue Code (such as HSA-qualified high-deductible health plans) if eliminating deductibles would cause the plan to lose its tax-exempt status

Filed July 25, 2025 and received favorable "ought to pass" recommendation from the House Financial Services Committee on July 31, 2025