Text of MA H 4271 (2025)

1 of 22 HOUSE . . . . . . . . . . . . . . . No. 4271 The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Fourth General Court (2025-2026) _______________ By striking out all after the enacting clause and inserting in place thereof the following:– 1 SECTION 1. Clause Twenty-sixth of section 7 of chapter 4 of the General Laws, as 2 amended by section 1 of chapter 363 of the acts of 2024, is hereby further amended by adding 3 the following subclause:- 4 (x) the name, home address, personal email address, home telephone number or mobile 5 telephone number and any other personal information of an individual engaged in the provision, 6 facilitation or promotion of reproductive health care services or gender-affirming health care 7 services, as defined in section 11I1/2 of chapter 12. 8 SECTION 2. Section 11I1/2 of chapter 12 of the General Laws, as appearing in the 2022 9 Official Edition, is hereby amended by adding the following 3 subsections:- 10 (g) Notwithstanding any general or special law to the contrary and except as required by 11 federal law, no state or local agency of the commonwealth or officer or employee or any other 12 person acting on behalf of a state or local agency of the commonwealth while acting under the 13 color of law shall cooperate with or provide information or assistance to any federal law 14 enforcement agency or other agency or any other state or local law enforcement agency or other 15 agency or any individual or quasi-law enforcement agent or expend or use any time, money, 2 of 22 16 facilities, property, equipment, personnel or other resources in relation to an investigation or 17 inquiry into services constituting legally-protected health care activity if such services would be 18 lawful as provided had they occurred entirely in the commonwealth. 19 (h) Evidence relating to the involvement of an individual in any legally-protected health 20 care activity shall not be offered as evidence that such individual has engaged in wrongdoing, 21 whether civil, criminal, professional or otherwise, by virtue of the fact that the individual who 22 received such services was not physically present in the commonwealth when they received such 23 services. Nothing in this section shall prevent a party from offering such evidence in a 24 proceeding that: (i) sounds in tort or contract; (ii) is actionable, in an equivalent or similar 25 manner, under the laws of the commonwealth; and (iii) was brought by the patient who received 26 reproductive health care services or gender-affirming health care services or the patient’s legal 27 representative. 28 (i) The attorney general may bring a civil action for injunctive or other equitable relief to 29 enforce this section. 30 SECTION 3. Section 12 of chapter 12C of the General Laws, as amended by section 24 31 of chapter 342 of the acts of 2024, is hereby further amended by striking out subsection (b) and 32 inserting in place thereof the following 8 subsections:- 33 (b) The center shall permit a government agency or authority to access identifiable health 34 information of an individual only to the extent necessary for such government agency or 35 authority to accomplish the public purposes for which access was given, subject to subsection (f). 36 Except as required by federal law, the center shall not provide access to any data, including de- 37 identified data or any other data that would allow the identification of a patient or provider in 3 of 22 38 response to an out-of-state or federal inquiry or investigation into services constituting legally- 39 protected health care activity, as defined in section 11I1/2 of chapter 12. 40 (c) The center shall permit providers, provider organizations and public and private 41 health care payers access to identifiable health information of an individual solely for the 42 purposes of carrying out treatment, payment or health care operations. 43 (d) The center may disclose identifiable health information of an individual for research, 44 regardless of the source of funding of the research; provided, that: (i) the center obtains 45 documentation of authorization from the individual patient; or (ii) waiver of individual 46 authorization has been approved by either an institutional review board or privacy board. 47 (e) The center may disclose de-identified health information of an individual for the 48 purposes of lowering total medical expenses, coordinating care, benchmarking, quality analysis, 49 research, administrative or planning purposes, informing consumer health care decisions or other 50 purposes that aim to improve healthcare or public health outcomes for commonwealth residents 51 that are consistent with the goals of this chapter. A recipient of de-identified health information 52 of an individual shall not use such information or data to identify any person for any purpose. 53 (f) A recipient of de-identified or identifiable health information of an individual patient 54 shall not use such information to: (i) conduct a criminal, civil or administrative investigation into 55 any individual patient; or (ii) impose criminal, civil or administrative liability on any individual 56 patient. 57 (g) Access to identifiable health information of an individual, including personal data as 58 defined in section 1 of chapter 66A, authorized under this section shall be deemed to comply 59 with the requirements of chapter 66A. 4 of 22 60 (h) The center may charge an application fee or other fees sufficient to process and 61 provide such access to non-governmental entities. 62 (i) A violation of subsection (f), or any rule or regulation issued thereunder, shall 63 constitute a violation of chapter 93A. 64 SECTION 4. Section 75 of chapter 31 of the General Laws, inserted by section 161 of 65 chapter 238 of the acts of 2024, is hereby amended by adding the following paragraph:- 66 Nothing in this section shall be construed to permit civil service employees to furnish 67 information to, or cooperate with, law enforcement authorities in contravention of section 11I1/2 68 of chapter 12 or section 63 of chapter 147. 69 SECTION 5. Section 10B of chapter 66 of the General Laws is hereby amended by 70 striking out, in lines 34 and 35, as appearing in the 2022 Official Edition, the words “persons 71 providing or training in family planning services” and inserting in place thereof the following 72 words:- persons engaged or trained in the provision, facilitation or promotion of reproductive 73 health care services or gender-affirming health care services, as defined in section 11I1/2 of 74 chapter 12,. 75 SECTION 6. Chapter 93 of the General Laws is hereby amended by adding the following 76 section:- 77 Section 115. (a) As used in this section, the following words shall, unless the context 78 clearly requires otherwise, have the following meanings: 79 “Electronic communication”, any transfer of signs, signals, writing, images, sounds, data 80 or intelligence of any nature transmitted in whole or in part by a wire, radio, electromagnetic, 5 of 22 81 photoelectronic or photo-optical system; provided, however, that such term shall not include any 82 communication: (i) made through a tone only paging device; or (ii) that is disseminated by the 83 sender through a method of transmission that is configured so that such communication is readily 84 accessible to the public. 85 “Electronic communication services”, any service which provides to users thereof the 86 ability to send or receive wire or electronic communications. 87 “Remote computing service”, as defined in 18 U.S.C. 2711. 88 (b) A business entity that operates in the commonwealth and provides electronic 89 communication services or remote computing service to residents of the commonwealth or to a 90 business entity organized under the laws of the commonwealth shall not comply with a 91 subpoena, warrant or other civil or criminal legal process for records, information or assistance 92 that the business entity knows relates to a resident, health care provider or business entity in the 93 commonwealth in connection with legally-protected health care activity as defined in section 94 11I1/2 of chapter 12, except as required by a valid federal law, unless the subpoena, warrant or 95 other civil or criminal legal process includes, or is accompanied by, an attestation, made under 96 penalty of perjury, stating that the subpoena, warrant or other civil or criminal legal process does 97 not seek documents, information or testimony relating to an investigation into, or the 98 enforcement of, another state’s law that asserts criminal or civil liability for the provision, 99 receipt, attempted provision or receipt, assistance in the provision or receipt or attempted 100 assistance in the provision or receipt of legally-protected health care activity that is lawful in the 101 commonwealth. 6 of 22 102 (c) Any false attestation submitted under this section shall be subject to a statutory 103 penalty of not more than $50,000 per violation. Submission of an attestation shall subject the 104 attester to the jurisdiction of the courts of the commonwealth for any suit, penalty or damages 105 arising out of a false attestation under this section. 106 (d) The attorney general may bring a civil action for injunctive or other equitable relief to 107 compel any business entity that operates in the commonwealth and that provides electronic 108 communications services or remote computing service to residents of the commonwealth or to a 109 business entity organized under the laws of the commonwealth to comply with this section. 110 SECTION 7. Section 21 of chapter 94C of the General Laws, as amended by section 6 of 111 chapter 285 of the acts of 2024, is hereby further amended by striking out the first paragraph and 112 inserting in place thereof the following 2 paragraphs:- 113 The pharmacist filling a written, electronic or oral prescription for a controlled substance 114 shall package the controlled substance in a container, affixing to the container a label showing 115 the date of filling, the pharmacy name and address, the filling pharmacist's initials, the serial 116 number of the prescription, the name of the patient, unless it is a veterinary prescription, the 117 name of the prescribing practitioner except as otherwise provided in this section, the name of the 118 controlled substance, directions for use and cautionary statements, if any, contained in such 119 prescription or required by law, and if the controlled substance is dispensed as tablets or 120 capsules, the number of same in such container. 121 Except as required by federal law, the label for a controlled substance prescribed for 122 reproductive health care services or gender-affirming health care services, as defined in section 123 11I1/2 of chapter 12, shall, at the request of the provider, include the name of the prescribing 7 of 22 124 health care practice instead of the name of the prescribing practitioner; provided, however, that a 125 pharmacy benefit manager, as defined in section 1 of chapter 176Y, shall not recoup or recover 126 funds from a pharmacy due to the absence of such dispensing practitioner’s name under this 127 paragraph. The department may promulgate regulations to implement this paragraph. 128 SECTION 8. Section 22 of said chapter 94C, as appearing in the 2022 Official Edition, is 129 hereby amended by adding the following subsection:- 130 (d) Notwithstanding subsection (b) and to the extent allowable under federal law, the 131 label for a controlled substance prescribed for reproductive health care services or gender- 132 affirming health care services, as defined in section 11I1/2 of chapter 12, may include the name 133 and address of the dispensing health care practice instead of the name and address of the 134 dispensing practitioner. 135 SECTION 9. Paragraph (1) of subsection (a) of section 24A of said chapter 94C, as so 136 appearing, is hereby amended by adding the following sentence:- 137 Notwithstanding any other provision of this section, medications that may be prescribed 138 for reproductive health care services and gender-affirming health care services, as defined in 139 section 11I1/2 of chapter 12, shall be excluded from the prescription monitoring program unless 140 reporting of such is determined by the department to be necessary to protect the public health. 141 SECTION 10. Said section 24A of said chapter 94C, as so appearing, is hereby further 142 amended by adding the following subsection:- 143 (n) Notwithstanding any general or special law to the contrary, except as required by 144 federal law, the department shall not provide disaggregated data or individually identifiable data 8 of 22 145 from the prescription drug monitoring program to a federal law enforcement agency or other 146 agency or any other state or local law enforcement agency or other agency or any private citizen 147 or entity or quasi-law enforcement agent in relation to an investigation or inquiry into 148 reproductive health care services or gender-affirming health care services, as defined in section 149 11I1/2 of chapter 12, if such services would be lawful as provided had they occurred entirely in 150 the commonwealth. This section shall not be construed to apply to prescription drugs for usages, 151 including off-label usages, that are unrelated to reproductive health care services or gender- 152 affirming health care services. 153 SECTION 11. Chapter 111 of the General Laws is hereby amended by inserting after 154 section 51 the following section:- 155 Section 511/4. (a) For purposes of this section, the following words shall, unless the 156 context clearly requires otherwise, have the following meanings: 157 “Emergency medical condition”, a medical condition manifesting itself by acute 158 symptoms of sufficient severity such that the absence of immediate medical attention could 159 reasonably be expected to result in: (i) placing the health of the patient in serious jeopardy; (ii) 160 serious impairment of bodily functions; or (iii) serious dysfunction of any bodily organ or part. 161 Emergency medical condition shall include, but shall not be limited to, ectopic pregnancy, 162 complications of pregnancy loss or abortion, active labor, risks to future fertility, preterm 163 premature rupture of membranes, placental abruption or bleeding from placenta previa or 164 emergent hypertensive disorders, such as preeclampsia and eclampsia and peripartum 165 cardiomyopathy, and any other condition a licensed health care provider, acting within their 9 of 22 166 lawful scope of practice, determines in the provider’s best medical judgment, to be an emergency 167 medical condition. 168 “Patient”, any person who presents at a hospital or who is brought to a hospital by 169 ambulance or specialized emergency medical services vehicle as defined in section 1 of chapter 170 111C. 171 “Stabilizing treatment”, includes abortion when abortion is necessary to resolve the 172 patient’s injury or emergency medical condition. 173 (b) Acute-care hospitals licensed under section 51G, during all operating hours of an 174 emergency department or a satellite emergency facility as defined in section 511/2, shall provide 175 hospital emergency services to any patient who presents with an injury or an emergency medical 176 condition. Acute-care hospitals shall furnish hospital emergency services, including, but not 177 limited to, medical screening by qualified medical personnel, to reach with reasonable clinical 178 confidence a determination of whether a patient has an emergency medical condition and to 179 provide necessary stabilizing treatment for patients with an emergency medical condition. Acute- 180 care hospitals shall establish and maintain policies and procedures for the provision of hospital 181 emergency services, including for a patient’s refusal to consent, restricting transfers until the 182 patient is stabilized, appropriate transfers of patients, nondiscrimination in providing services to 183 patients, preventing delay in examination or treatment of patients and whistleblower protections. 184 (c) The department may promulgate regulations to implement this section. 185 (d) The attorney general may bring a civil action for injunctive or other equitable relief to 186 enforce this section. In any action brought by the attorney general under this section, the court 187 may also award a civil penalty of not more than $10,000 for each violation. 10 of 22 188 SECTION 12. Said chapter 111 is hereby further amended by inserting after section 70H 189 the following section:- 190 Section 70I. (a) For the purposes of this section, the following words shall, unless the 191 context clearly requires otherwise, have the following meanings: 192 “Business”, (i) a business organized for the purpose of maintaining medical information 193 to make an individual’s medical information available to the individual or to a health care 194 provider at the request of the individual or a health care provider, for purposes of allowing the 195 individual or the provider to manage the individual’s medical information or for the diagnosis 196 and treatment of the individual; 197 (ii) a business that offers medical recordkeeping, electronic health records or electronic 198 medical record services, including, but not limited to, software or hardware, to consumers that 199 makes an individual’s medical information available to another person or a health care provider 200 at the request of the individual or a health care provider, for purposes of allowing the other 201 person or the provider to manage the individual’s medical information or for the diagnosis, 202 treatment or management of a medical condition of the individual; 203 (iii) a business that is licensed by the department or the department of mental health to 204 provide medical, clinical, behavioral or health services; or 205 (iv) a business that offers a digital service to a consumer for the purpose of allowing such 206 consumer to manage the consumer’s reproductive or sexual health information or for the 207 diagnosis, treatment or management of a reproductive or sexual health medical condition of the 208 consumer. 11 of 22 209 “Gender-affirming health care services”, as defined in section 11I1/2 of chapter 12. 210 “Reproductive health care services”, as defined in section 11I1/2 of chapter 12. 211 (b) A business that electronically stores or maintains medical information related to the 212 provision of reproductive health care services, in vitro fertilization and gender-affirming health 213 care services, including, but not limited to, on an electronic health record system or electronic 214 medical record system, on behalf of a health care provider, health care insurance plan, 215 pharmaceutical company, pharmacy benefit manager, contractor or employer, shall develop 216 capabilities, policies and procedures to enable and shall enable features that: 217 (i) limit user access privileges to information systems that contain medical information 218 related to reproductive health care services, in vitro fertilization and gender-affirming health care 219 services only to those persons who are authorized in writing by the patient to access such 220 medical information; 221 (ii) prevent the disclosure, access, transfer, transmission or processing of medical 222 information related to reproductive health care services, in vitro fertilization or gender-affirming 223 health care services to persons and entities outside of the commonwealth, absent the express 224 written consent of the patient, independent of any other agreement, that specifically authorizes 225 the disclosure, access, transfer, transmission or processing of such medical information to the 226 named persons or entities outside of the commonwealth; and 227 (iii) automatically disable access by individuals and entities outside the commonwealth to 228 segregated medical information related to reproductive health care services, in vitro fertilization 229 or gender-affirming health care services, absent the express written consent of the patient that 12 of 22 230 specifically authorizes access by named persons or entities outside of the commonwealth to such 231 segregated medical information. 232 (c) The department may promulgate such regulations as may be necessary to implement 233 this section. 234 (d) The department shall create a consent form that meets the requirements of this section 235 and shall require its use by all licensed health care providers in the commonwealth. 236 (e) The attorney general may bring a civil action for injunctive or other equitable relief to 237 enforce this section. In any action brought by the attorney general under this section, the court 238 may also award a civil penalty of not more than $5,000 per violation. 239 SECTION 13. Section 12Q of chapter 112 of the General Laws, as appearing in the 2022 240 Official Edition, is hereby amended by adding the following paragraph:- 241 The commissioner of public health shall not collect, maintain, use, disclose or 242 disseminate disaggregated surveillance data or individually identifiable surveillance data on 243 abortions performed in the commonwealth. The name, home address, personal email address, 244 home telephone number and mobile telephone number of individuals engaged in the provision, 245 facilitation or promotion of reproductive health care services, as defined in section 11I1/2 of 246 chapter 12, shall not be considered a public record under chapter 66. 247 SECTION 14. Said chapter 112 is hereby further amended by inserting after section 12Q 248 the following section:- 249 Section 12Q1/2. The commissioner of public health shall not collect, maintain or use 250 individually identifiable data on gender-affirming health care services provided in the 13 of 22 251 commonwealth, as defined in section 11I1/2 of chapter 12, except as authorized by law, and shall 252 not disclose or disseminate disaggregated data or individually identifiable surveillance data on 253 gender-affirming health care services provided in the commonwealth. The name, home address, 254 personal email address, home telephone number and mobile telephone number of individuals 255 engaged in the provision, facilitation or promotion of gender-affirming health care services shall 256 not be considered a public record under chapter 66. 257 SECTION 15. Section 61 of said chapter 112, as most recently amended by section 2 of 258 chapter 353 of the acts of 2024, is hereby further amended by adding the following 3 259 paragraphs:- 260 Notwithstanding any general or special law to the contrary, no person shall be subject to 261 discipline by a board of registration, including through the revocation, suspension or cancellation 262 of a certificate, registration or license, or a reprimand, censure or monetary fine, for providing or 263 assisting in the provision of reproductive health care services or gender-affirming health care 264 services, as those terms are defined in section 11I1/2 of chapter 12, or for any judgment, 265 discipline or other sanction arising from the health care services if the services as provided 266 would have been lawful and consistent with the standard of conduct for the designated profession 267 had they occurred entirely in the commonwealth. 268 No board of registration shall make available for public dissemination on an individual’s 269 profile the record of any criminal conviction or charge for a felony or serious misdemeanor, final 270 disciplinary action by a licensing board in another state or a malpractice court judgment, 271 arbitration award or settlement that resulted from providing or assisting in the provision of 272 reproductive health care services or gender-affirming health care services or for any judgment, 14 of 22 273 discipline or other sanction arising from the health care services if the services as provided 274 would have been lawful and consistent with the scope and standards of practice for the 275 designated profession had they occurred entirely in the commonwealth. 276 No board of registration shall take adverse action on an application for a certificate, 277 registration or licensure based on a criminal or civil action or disciplinary action by a licensing 278 board of another state or a medical malpractice claim in another state that resulted from 279 providing or assisting in the provision of reproductive health care services or gender-affirming 280 health care services that, as provided, would have been lawful and consistent with the standard of 281 conduct for the designated profession had the health care services occurred entirely in the 282 commonwealth. 283 SECTION 16. Section 26 of chapter 119 of the General Laws, as appearing in the 2022 284 Official Edition, is hereby amended by adding the following subsection:- 285 (d) The removal of a child from the care or custody of a parent, custodian or guardian in 286 another jurisdiction based on the parent, custodian or guardian allowing their child to seek or 287 receive gender-affirming health care services, as defined in section 11I1/2 of chapter 12, shall 288 not provide a basis for adjudicating the child in need of care and protection under this section 289 unless the conduct of the parent, custodian or guardian would otherwise constitute abuse or 290 neglect under the laws of the commonwealth. 291 SECTION 17. Section 63 of chapter 147 of the General Laws, as so appearing, is hereby 292 amended by striking out subsection (b) and inserting in place thereof the following 2 293 subsections:- 15 of 22 294 (b) Notwithstanding any general or special law to the contrary and except as required by 295 federal law, no state or local law enforcement agency or officer or employee or any other person 296 acting on behalf of a state or local law enforcement agency of the commonwealth, while acting 297 under color of law, shall provide information or assistance to a federal law enforcement agency 298 or any other state’s agency, including a law enforcement agency, or any private citizen or quasi- 299 law enforcement agent, or expend or use time, money, facilities, property, equipment, personnel 300 or other resources in relation to an investigation or inquiry into services constituting legally- 301 protected health care activity, as defined in section 11I1/2 of chapter 12, if the services would be 302 lawful as provided had the services occurred entirely in the commonwealth. 303 (c) The attorney general may bring a civil action for injunctive or other equitable relief to 304 enforce this section. 305 SECTION 18. Chapter 175 of the General Laws is hereby amended by inserting after 306 section 193U the following section:- 307 Section 193V. No insurance company offering for sale any policy of insurance shall 308 discriminate against an organization that is exempt from taxation under section 501(c)(3) of the 309 Internal Revenue Code, or adjust or otherwise calculate such organization’s risk classification or 310 premium charges in the provision of any form of liability insurance covering negligence, 311 wrongful acts, errors or omissions of the organization and its respective members, directors and 312 officers, on the basis that: (i) the organization offers reproductive health care services or gender- 313 affirming health care services, as those terms are defined in section 11I1/2 of chapter 12; (ii) the 314 organization engages in legally-protected health care activity, as defined in said section 11I1/2 of 315 said chapter 12; or (iii) the organization is or has been the subject of abusive litigation, as defined 16 of 22 316 in said section 11I1/2 of said chapter 12. Nothing herein shall prohibit such insurers from 317 establishing reasonable classifications of risks and premium charges based upon the relative risk 318 associated with practice in a particular specialty. 319 SECTION 19. Chapter 176Q of the General Laws is hereby amended by adding the 320 following section:- 321 Section 19. (a) Except as required by federal law, the connector shall not provide access 322 to any data, including de-identified data or any other data that would allow the identification of a 323 patient, applicant or provider, in response to an out-of-state or federal inquiry or investigation 324 into services constituting legally-protected health care activity, as defined in section 11I1/2 of 325 chapter 12. 326 (b) The connector shall grant providers, provider organizations and public and private 327 health care payers access to identifiable health information or other personally identifiable 328 information of an individual solely for the purposes of carrying out treatment, payment, health 329 care operations or its functions as a health insurance exchange. 330 (c) The connector shall not disclose, disseminate, transfer or otherwise allow access to 331 identifiable health information or other personally identifiable information of an individual for 332 any purpose not expressly authorized by this chapter. 333 (d) A recipient of de-identified or identifiable health information or other personally 334 identifiable information of an individual patient or applicant shall not use such information to: (i) 335 conduct a criminal, civil or administrative investigation into any individual patient; or (ii) impose 336 criminal, civil or administrative liability on any individual patient. 17 of 22 337 SECTION 20. Chapter 208 of the General Laws is hereby amended by adding the 338 following section:- 339 Section 56. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 340 to be removed from the care or custody of a parent or guardian based on the parent or guardian 341 allowing their child to receive gender-affirming health care services, as defined in section 11I1/2 342 of chapter 12, or that bans the provision of gender-affirming health care services shall not 343 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 344 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 345 conduct of the parent or guardian under such law would constitute abuse, neglect or 346 maltreatment under the laws of the commonwealth. 347 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 348 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 349 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 350 parent or guardian is criminally, civilly or otherwise liable for violating another state’s law that 351 bans the provision of gender-affirming health care services as evidence in any proceeding with 352 respect to that parent or guardian and any of their children, unless the conduct of the parent or 353 guardian would constitute abuse, neglect or maltreatment under the laws of the commonwealth. 354 (c) Notwithstanding any provision of this chapter to the contrary, when deciding whether 355 to alter custody, parenting time or visitation a court in the commonwealth shall consider the 356 likely disruption or cessation of gender-affirming health care services, as defined in section 357 11I1/2 of chapter 12, as a result of a law of a jurisdiction outside the commonwealth that 358 prohibits gender-affirming health care services or authorizes a child to be removed from the care 18 of 22 359 or custody of a parent or guardian based on the parent or guardian allowing their child to receive 360 gender-affirming care health care services. 361 SECTION 21. Chapter 209A of the General Laws is hereby amended by adding the 362 following section:- 363 Section 12. (a) Notwithstanding section 5A or any other general or special law to the 364 contrary, a law of a jurisdiction outside the commonwealth that authorizes a child to be removed 365 from the care or custody of a parent or guardian based on the parent or guardian allowing their 366 child to receive gender-affirming health care services, as defined in section 11I1/2 of chapter 12, 367 or that bans the provision of gender-affirming health care services shall not provide a basis to 368 alter custody, parenting time or visitation or be used to make a finding of abuse, neglect or 369 maltreatment in a case pending in a court in the commonwealth, unless the conduct of the parent 370 or guardian would constitute abuse, neglect or maltreatment under the laws of the 371 commonwealth. 372 (b) Notwithstanding section 5A or any other general or special law to the contrary, no 373 court in the commonwealth shall admit or consider a finding of abuse, neglect or maltreatment 374 based on a parent or guardian allowing their child to receive or seek gender-affirming health care 375 services, as defined in section 11I1/2 of chapter 12, or a finding that a parent or guardian is 376 criminally, civilly or otherwise liable for violating another state’s law that bans the provision of 377 gender-affirming health care services as evidence in any proceeding in which such parent or 378 guardian and any of such parent’s or guardian’s children are parties, unless the conduct of the 379 parent or guardian would constitute abuse, neglect or maltreatment under the laws of the 380 commonwealth. 19 of 22 381 (c) Notwithstanding section 5A or any other general or special law to the contrary, when 382 deciding whether to alter custody, parenting time or visitation a court in the commonwealth shall 383 consider the likely disruption or cessation of gender-affirming health care services, as defined in 384 section 11I1/2 of chapter 12, as a result of a law of a jurisdiction outside the commonwealth that 385 prohibits gender-affirming health care services or authorizes a child to be removed from the care 386 or custody of a parent or guardian based on the parent or guardian allowing their child to receive 387 gender-affirming care health care services. 388 SECTION 22. Chapter 209B of the General Laws is hereby amended by adding the 389 following section:- 390 Section 15. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 391 to be removed from the care or custody of a parent or guardian based on the parent or guardian 392 allowing their child to receive gender-affirming care health care services, as defined in section 393 11I1/2 of chapter 12, or that bans the provision of gender-affirming health care services shall not 394 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 395 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 396 conduct of the parent or guardian would constitute abuse, neglect or maltreatment under the laws 397 of the commonwealth. 398 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 399 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 400 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 401 parent or guardian is criminally, civilly or otherwise liable for violating another state’s law that 402 bans the provision of gender-affirming health care services as evidence in any proceeding with 20 of 22 403 respect to that parent or guardian and any of their children, unless the conduct of the parent or 404 guardian would constitute abuse, neglect or maltreatment under the laws of the commonwealth. 405 (c) Notwithstanding any provision of this chapter to the contrary, when deciding whether 406 to alter custody, parenting time or visitation a court in the commonwealth shall consider the 407 likely disruption or cessation of gender-affirming health care services, as defined in section 408 11I1/2 of chapter 12, as a result of a law of a jurisdiction outside the commonwealth that 409 prohibits gender-affirming health care services or authorizes a child to be removed from the care 410 or custody of a parent or guardian based on the parent or guardian allowing their child to receive 411 gender-affirming care health care services. 412 SECTION 23. Chapter 209C of the General Laws is hereby amended by adding the 413 following section:- 414 Section 25Q. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 415 to be removed from the care or custody of a parent or guardian based on the parent or guardian 416 allowing their child to receive gender-affirming health care services, as defined in section 11I1/2 417 of chapter 12, or that bans the provision of gender-affirming health care services shall not 418 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 419 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 420 conduct of the parent or guardian would constitute abuse, neglect or maltreatment under the laws 421 of the commonwealth. 422 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 423 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 424 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 21 of 22 425 parent or guardian is criminally, civilly or otherwise liable for violating another state’s law that 426 bans the provision of gender-affirming health care services as evidence in any proceeding in 427 which such parent or guardian and any of such parent’s or guardian’s children are parties, unless 428 the conduct of such parent or guardian would constitute abuse, neglect or maltreatment under the 429 laws of the commonwealth. 430 (c) Notwithstanding any provision of this chapter to the contrary, when deciding whether 431 to alter custody, parenting time or visitation a court in the commonwealth shall consider the 432 likely disruption or cessation of gender-affirming health care services, as defined in section 433 11I1/2 of chapter 12, as a result of a law of a jurisdiction outside the commonwealth that 434 prohibits gender-affirming health care services or authorizes a child to be removed from the care 435 or custody of a parent or guardian based on the parent or guardian allowing their child to receive 436 gender-affirming care health care services. 437 SECTION 24. Chapter 221 of the General Laws is hereby amended by inserting after 438 section 42 the following section:- 439 Section 42A. Notwithstanding any general or special law or rule or regulation to the 440 contrary, no attorney licensed in the commonwealth shall be removed or otherwise subject to 441 discipline, including through the revocation, suspension or cancellation of the attorney’s license 442 or reprimand, censure or monetary fine, for advising or representing a client or prospective client 443 on or in a matter related to the provision of reproductive health care services or gender-affirming 444 health care services, as those terms are defined in section 11I1/2 of chapter 12, if the sole basis 445 for such removal or discipline is that: (i) the client offered, provided or received reproductive 446 health care services or gender-affirming health care services that are unlawful in another state; 22 of 22 447 (ii) another state’s laws create actual or potential liability for the reproductive health care 448 services or gender-affirming health care services offered, provided or received by the client; or 449 (iii) the attorney is subject to actual or potential liability, or removal or discipline, in another 450 jurisdiction based on the reproductive health care services or gender-affirming health care 451 services offered, provided or received by the client; provided, however, that the attorney’s 452 conduct shall otherwise comply with the laws of the commonwealth and meet the standards set 453 forth in the rules of professional conduct promulgated by the supreme judicial court. 454 SECTION 25. Section 7 shall take effect January 1, 2026. 455 SECTION 26. Section 12 shall take effect July 1, 2027.