MA S692

Requires MassHealth and its contracted health insurers, health plans, HMOs, and third-party administrators to cover patient navigation services provided by community health workers

Defines covered patient navigation services to include chronic disease prevention and screening, social needs assessments and referrals, health education, health coaching, assistance overcoming cultural and language barriers, and diagnosis-related patient education

Limits reimbursement to community health workers who have completed a national patient navigation certification program or other training approved by the Executive Office of Health and Human Services

Directs the Executive Office of Health and Human Services to obtain federal authorization and maximize federal financial participation for these benefits

Applies to all contracts entered into, renewed, or amended on or after January 1, 2026