MA S867

Establishes mandatory primary care expenditure targets for Massachusetts health care entities: 8% of total health care expenditures by 2027, 10% by 2028, and 12% by 2029 and beyond, with enforcement through performance improvement plans and civil penalties up to $500,000-$750,000 for non-compliance

Creates a Primary Care Board within the Health Policy Commission to study primary care access, develop workforce plans, propose payment models, and design a standard all-payer primary care capitation model with per-member per-month payments adjusted for quality, clinical complexity, and advanced services

Requires all health insurers to implement the all-payer primary care capitation model by July 1, 2028, offering participating providers prospective monthly payments with enhanced rates for advanced services like behavioral health integration, community health workers, and same-day appointments

Mandates that Federally Qualified Health Centers receive reimbursement from all payers at rates at least equivalent to MassHealth methodology, and requires behavioral health urgent care providers receive a minimum 20% rate add-on over negotiated fee schedules

Eliminates patient cost-sharing for emergency psychiatric services and behavioral health urgent care services, and requires payment for community behavioral health center services at bundled rates matching MassHealth rates