Text of MA H 5090 (2022)

1 of 31 HOUSE . . . . . . . . . . . . . . No. 5090 The Commonwealth of Massachusetts _______________ The committee of conference on the disagreeing votes of the two branches with reference to the Senate amendments (striking out all after the enacting clause and inserting in place thereof the text contained in Senate document numbered 3003; striking out the emergency preamble and inserting in place thereof the following emergency preamble: “Whereas, The deferred operation of this act would tend to defeat its purpose, which is to expand protections for reproductive and gender-affirming care, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public convenience.”; and striking out the title and inserting in place thereof the following title: “An Act expanding protections for reproductive and gender-affirming care”) of the House Bill expanding protections for reproductive rights (House, No. 4954), reports recommending passage of the accompanying bill (House, No. 5090). July 25, 2022. Aaron Michlewitz Cindy F. Friedman Michael S. Day Cynthia Stone Creem Kimberly N. Ferguson Bruce E. Tarr 2 of 31 FILED ON: 7/25/2022 HOUSE . . . . . . . . . . . . . . . No. 5090 The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Second General Court (2021-2022) _______________ An Act expanding protections for reproductive and gender-affirming care. Whereas, The deferred operation of this act would tend to defeat its purpose, which is to expand protections for reproductive and gender-affirming care, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public convenience. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: 1 SECTION 1. Section 1 of chapter 9A of the General Laws, as appearing in the 2020 2 Official Edition, is hereby amended by inserting after the definition of “Application assistant” 3 the following 3 definitions:- 4 “Gender-affirming health care services”, all supplies, care and services of a medical, 5 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, 6 rehabilitative or supportive nature relating to the treatment of gender dysphoria. 7 “Legally-protected health care activity”, (i) the exercise and enjoyment, or attempted 8 exercise and enjoyment, by any person of rights to reproductive health care services or gender- 9 affirming health care services secured by the constitution or laws of the commonwealth or the 10 provision of insurance coverage for such services; or (ii) any act or omission undertaken to aid or 11 encourage, or attempt to aid or encourage, any person in the exercise and enjoyment, or 3 of 31 12 attempted exercise and enjoyment, of rights to reproductive health care services or gender- 13 affirming health care services secured by the constitution or laws of the commonwealth or to 14 provide insurance coverage for such services; provided, however, that the provision of such a 15 health care service by a person duly licensed under the laws of the commonwealth and physically 16 present in the commonwealth and the provision of insurance coverage for such services shall be 17 legally protected if the service is permitted under the laws of the commonwealth, regardless of 18 the patient’s location; and provided further, that “legally-protected health care activity” shall not 19 include any service rendered below an applicable professional standard of care or that would 20 violate anti-discrimination laws of the commonwealth. 21 “Reproductive health care services”, all supplies, care and services of a medical, 22 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, 23 rehabilitative or supportive nature relating to pregnancy, contraception, assisted reproduction, 24 miscarriage management or the termination of a pregnancy. 25 SECTION 2. Section 2 of said chapter 9A, as so appearing, is hereby amended by 26 striking out subsection (1) and inserting in place thereof the following subsection:- 27 (1)(a) Upon recommendation of an application assistant, an adult person, a parent or 28 guardian acting on behalf of a minor or a guardian acting on behalf of an incapacitated person 29 may apply to the secretary to have an address designated by the secretary serve as the person’s 30 address or the address of the minor or incapacitated person. 31 (b) Individuals engaged in the provision, facilitation or promotion of legally-protected 32 health care activity may apply to the secretary to have an address designated by the secretary 4 of 31 33 serve as the health care professional’s address; provided, however, that in such cases, no 34 recommendation of an application assistant shall be required. 35 SECTION 3. Said chapter 9A is hereby further amended by striking out section 7, as so 36 appearing, and inserting in place thereof the following section:- 37 Section 7. The secretary shall promulgate regulations to implement this chapter and in 38 doing so shall consult with the secretary of health and human services, Jane Doe Inc.: The 39 Massachusetts Coalition Against Sexual Assault and Domestic Violence, GLBTQ Legal 40 Advocates & Defenders, Inc., Planned Parenthood League of Massachusetts, Inc., ABCD, Inc. 41 on behalf of the MA Family Planning Association, The Massachusetts League of Community 42 Health Centers, Inc., the Maternal Outcomes for Translational Health Equity Research Lab, 43 Resilient Sisterhood Project, Inc., Health Care Without Walls, Inc., Our Bodies Ourselves and 44 Reproductive Equity Now, Inc. 45 SECTION 4. Chapter 12 of the General Laws is hereby amended by inserting after 46 section 11I the following 2 sections:- 47 Section 11I½. (a) As used in this section, the following words shall have the following 48 meanings unless the context clearly requires otherwise: 49 “Gender-affirming health care services”, all supplies, care and services of a medical, 50 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, 51 rehabilitative or supportive nature relating to the treatment of gender dysphoria. 52 “Abusive litigation”, litigation or other legal action to deter, prevent, sanction or punish 53 any person engaging in legally-protected health care activity by: (i) filing or prosecuting any 5 of 31 54 action in any state other than the commonwealth where liability, in whole or part, directly or 55 indirectly, is based on legally-protected health care activity that occurred in the commonwealth, 56 including any action in which liability is based on any theory of vicarious, joint or several 57 liability derived therefrom; or (ii) attempting to enforce any order or judgment issued in 58 connection with any such action by any party to the action or any person acting on behalf of a 59 party to the action; provided, however, that a lawsuit shall be considered to be based on conduct 60 that occurred in the commonwealth if any part of any act or omission involved in the course of 61 conduct that forms the basis for liability in the lawsuit occurs or is initiated in the 62 commonwealth, whether or not such act or omission is alleged or included in any pleading or 63 other filing in the lawsuit. 64 “Legally-protected health care activity”, (i) the exercise and enjoyment, or attempted 65 exercise and enjoyment, by any person of rights to reproductive health care services or gender- 66 affirming health care services secured by the constitution or laws of the commonwealth or the 67 provision of insurance coverage for such services; or (ii) any act or omission undertaken to aid or 68 encourage, or attempt to aid or encourage, any person in the exercise and enjoyment, or 69 attempted exercise and enjoyment, of rights to reproductive health care services or gender- 70 affirming health care services secured by the constitution or laws of the commonwealth; 71 provided, however, that the provision of such a health care service by a person duly licensed 72 under the laws of the commonwealth and physically present in the commonwealth and the 73 provision of insurance coverage for such services shall be legally protected if the service is 74 permitted under the laws of the commonwealth, regardless of the patient's location; and provided 75 further, that “legally-protected health care activity” shall not include any service rendered below 6 of 31 76 an applicable professional standard of care or that would violate anti-discrimination laws of the 77 commonwealth. 78 “Reproductive health care services”, all supplies, care and services of a medical, 79 behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, 80 rehabilitative or supportive nature relating to pregnancy, contraception, assisted reproduction, 81 miscarriage management or the termination of a pregnancy. 82 (b) Access to reproductive health care services and gender-affirming health care services 83 is a right secured by the constitution and laws of the commonwealth. Interference with this right, 84 whether or not under the color of law, is against the public policy of the commonwealth. 85 (c) Any public act or record of a foreign jurisdiction that prohibits, criminalizes, 86 sanctions, authorizes a person to bring a civil action against or otherwise interferes with a person, 87 provider, carrier or other entity in the commonwealth that seeks, receives, causes, aids in access 88 to, aids or abets or provides, or attempts or intends to seek, receive, cause, aid in access to, aid or 89 abet or provide, reproductive health care services or gender-affirming health care services shall 90 be an interference with the exercise and enjoyment of the rights secured by the constitution and 91 laws of the commonwealth and shall be a violation of the public policy of the commonwealth. 92 (d) If a person, including any plaintiff, prosecutor, attorney or law firm, whether or not 93 acting under color of law, engages or attempts to engage in abusive litigation that infringes on, 94 interferes with or attempts to infringe on or interfere with legally-protected health care activity, 95 any aggrieved person, provider, carrier or other entity, including any defendant in such abusive 96 litigation, may institute and prosecute a civil action for injunctive, monetary or other appropriate 97 relief within 3 years after the cause of action accrues. 7 of 31 98 Any aggrieved person, provider, carrier or other entity, including any defendant in such 99 abusive litigation, may move to modify or quash any subpoena issued in connection with such 100 abusive litigation on the grounds that the subpoena is unreasonable, oppressive or inconsistent 101 with the public policy of the commonwealth pursuant to the Massachusetts Rules of Civil 102 Procedure. 103 If the court finds for the petitioner in an action authorized by this section, recovery shall 104 be in the amount of actual damages, which shall include damages for the amount of any 105 judgment issued in connection with any abusive litigation, and any and all other expenses, costs 106 or reasonable attorney’s fees incurred in connection with the abusive litigation. 107 (e) A court may exercise jurisdiction over a person in an action authorized by this section 108 if: (i) personal jurisdiction is found under section 3 of chapter 223A; (ii) the person has 109 commenced any action in any court in the commonwealth and, during the pendency of that 110 action or any appeal therefrom, a summons and complaint is served on the person or the attorney 111 appearing on the person’s behalf in that action or as otherwise permitted by law; or (iii) the 112 exercise of jurisdiction is permitted under the Constitution of the United States. 113 (f) This section shall not apply to a lawsuit or judgment entered in another state that is 114 based on conduct for which a cause of action exists under the laws of the commonwealth if the 115 course of conduct that forms the basis for liability had occurred entirely in the commonwealth, 116 including any contract, tort, common law or statutory claims. 117 Section 11I¾. Notwithstanding any general or special law or common law conflict of law 118 rule to the contrary, the laws of the commonwealth shall govern in any case or controversy heard 8 of 31 119 in the commonwealth related to reproductive health care services or gender-affirming health care 120 services, as those terms are defined in section 11I½, except as may be required by federal law. 121 SECTION 5. Section 105 of chapter 13 of the General Laws, as amended by section 23 of 122 chapter 39 of the acts of 2021, is hereby further amended by adding the following 2 paragraphs:- 123 Notwithstanding any general or special law or rule or regulation to the contrary, a person 124 licensed under this section or in accordance with sections 255 or 256 of chapter 112, shall not be 125 subject to discipline by the board, including the revocation, suspension or cancellation of the 126 certificate of registration or reprimand, censure or monetary fine, for providing or assisting in the 127 provision of reproductive health care services or gender-affirming health care services, as those 128 terms are defined in section 11I½ of chapter 12, or for any judgment, discipline or other sanction 129 arising from such health care services if the services as provided would have been lawful and 130 consistent with the standards of conduct for genetic counselors if they occurred entirely in the 131 commonwealth; provided further, that the board shall not take adverse action on an application 132 for registration of a qualified genetic counselor based on a criminal or civil action or disciplinary 133 action by a licensing board of another state that arises from such health care services that, as 134 provided, would have been lawful and consistent with the standards of conduct for genetic 135 counselors if they occurred entirely in the commonwealth. 136 Nothing in this section shall be construed to regulate the practice of genetic counselors in 137 any other state. 138 SECTION 6. Chapter 15A of the General Laws is hereby amended by adding the 139 following 2 sections:- 9 of 31 140 Section 46. (a) As used in this section and section 47, the following words shall have the 141 following meanings unless the context clearly requires otherwise: 142 “Institution”, a public institution of higher education listed in section 5. 143 “Medication abortion”, abortion provided by medication techniques. 144 “Medication abortion readiness”, each institution’s preparedness to provide medication 145 abortions to students or assist students in obtaining medication abortions, including, but not 146 limited to, having in place equipment, protocols, patient educational materials, informational 147 websites and training for staff; provided, however, that “medication abortion readiness” may 148 include the provision of medication abortions. 149 “Health center”, a clinic or health center providing primary health care services to 150 students operated by an institution. 151 (b)(1) Each institution shall develop a medication abortion readiness plan for its students. 152 (2) The department of public health shall issue guidance to all institutions regarding the 153 required contents of medication abortion readiness plans in accordance with the varied 154 capabilities of institutions to provide services including, but not limited to, directly providing 155 medication abortions to students in a health center, providing referrals for abortion care services 156 not provided in the health center or providing information to students about obtaining a 157 medication abortion. In developing the guidance, the department shall consider factors including, 158 but not limited to, whether the institution has an operational health center on campus, the 159 institution’s proximity to a hospital, clinic or other facility that provides medication abortion, 160 availability, convenience and cost of public transportation between the institution and closest 10 of 31 161 facility that provides medication abortion and whether the institution employs health care 162 workers on campus. 163 (3) The department of public health shall review medication abortion readiness plans 164 annually, taking into consideration any changes to the capacity of each institution to provide 165 services to students since the preceding approval of the plan. 166 (c) Each institution shall annually submit any amendments or revisions to its medication 167 abortion readiness plan to the department of public health. 168 (d) Annually, not later than January 31, the department of public health shall determine 169 whether the plan is adequate in proportion to each institution’s capacity. The department shall 170 provide further guidance to institutions with plans deemed inadequate that includes remedial 171 measures for the institution to develop an adequate plan. 172 Section 47. (a) There shall be established and set up on the books of the commonwealth a 173 separate fund to be known as the Public University Health Center Sexual and Reproductive 174 Health Preparation Fund for the purpose of medication abortion readiness. The fund shall be 175 administered by the department of public health, in consultation with the department of higher 176 education. The fund shall be credited with: (i) revenue from appropriations or other money 177 authorized by the general court and specifically designated to be credited to the fund; and (ii) 178 funds from non-state entities, including, but not limited to, gifts, grants and donations from 179 private entities and local and federal government agencies. Amounts credited to the fund shall 180 not be subject to further appropriation and any money remaining in the fund at the end of a fiscal 181 year shall not revert to the General Fund. 182 (b) The department of public health shall utilize money in the fund to: 11 of 31 183 (i) provide a grant to each health center to pay for the cost of direct and indirect 184 medication abortion readiness; provided, however, that, the department shall prioritize 185 applications from the University of Massachusetts and state university segments and create a 186 simple application process for community colleges to apply for funding; and provided further, 187 that allowable expenses under these grants shall include, but not be limited to: (A) the purchase 188 of equipment used in the provision of medication abortions; (B) facility and security upgrades; 189 (C) costs associated with enabling the health center to deliver telehealth services; (D) costs 190 associated with training staff in the provision of medication abortions; (E) staff cost 191 reimbursement and clinical revenue offset while staff are in trainings; and (F) billing specialist 192 consultation; 193 (ii) pay the direct and indirect costs of the department of public health associated with 194 administration of the fund, including the costs of hiring staff; and 195 (iii) maintain a system of financial reporting on all aspects of the fund. 196 (c) Each health center grantee shall, as a condition of receiving a grant award from the 197 fund, participate in an evaluation of its medication abortion readiness and its provision of 198 medication abortions. 199 (d) The department of public health, working with the health centers, shall assist and 200 advise on potential pathways for health centers to access public and private payers to provide 201 funding for ongoing costs of providing medication abortions. 202 (e)(1) Annually, not later than December 31, the department of public health shall submit 203 a report to the clerks of the senate and house of representatives, including, but not limited to, all 204 of the following information for each reporting period: 12 of 31 205 (i) an accounting of the medication abortion plans of all institutions, including, but not 206 limited to, a list of institutions that have submitted plans deemed adequate by the department, a 207 list of institutions that are actively developing a remedial plan and a list of institutions that have 208 not submitted an adequate plan to the department; 209 (ii) the number of medication abortions provided at health centers, disaggregated, to the 210 extent possible, by the health center; 211 (iii) the total amount of funds granted by the department of public health to each 212 institution and its health center from the fund that is expended on medication abortion readiness 213 and the total amount of any other funds expended on medication abortion readiness and the 214 source of those funds, disaggregated by use and, to the extent possible, health center; and 215 (iv) the total amount of funds expended on the provision of medication abortions and the 216 source of those funds, disaggregated by use and, to the extent possible, health center. 217 (2) The report required in paragraph (1) and any associated data collected shall comply 218 with state and federal privacy laws, including, but not limited to, section 70E of chapter 111, the 219 federal Family Educational Rights and Privacy Act of 1974, 20 U.S.C. 1232g and the federal 220 Health Insurance Portability and Accountability Act of 1996, Public Law 104-191. 221 SECTION 7. Section 17C of chapter 32A of the General Laws, as appearing in the 2020 222 Official Edition, is hereby amended by inserting after the word “for”, in line 3, the following 223 words:- abortion as defined in section 12K of chapter 112, abortion-related care,. 224 SECTION 8. Said section 17C of said chapter 32A, as so appearing, is hereby further 225 amended by inserting after the second paragraph the following 2 paragraphs:- 13 of 31 226 Coverage provided under this section for abortion or abortion-related care shall not be 227 subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; 228 provided, however, that deductibles, coinsurance or copayments shall be required if the 229 applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt 230 status as a result of the prohibition on deductibles, coinsurance or copayments for these services. 231 Coverage for abortion or abortion-related care offered under this section shall not impose 232 unreasonable restrictions or delays in the coverage. 233 Benefits for an enrollee under this section shall be the same for the enrollee’s covered 234 spouse and covered dependents. 235 SECTION 9. Chapter 94C of the General Laws is hereby amended by striking out section 236 19A, as so appearing, and inserting in place thereof the following section:- 237 Section 19A. (a) As used in this section, unless the context clearly requires otherwise, 238 “emergency contraception” shall mean any drug approved by the federal Food and Drug 239 Administration as a contraceptive method for use after sexual intercourse, whether provided 240 over-the-counter or by prescription. 241 (b) The department shall ensure that a statewide standing order is issued to authorize the 242 dispensing of emergency contraception by a licensed pharmacist. The statewide standing order 243 shall include, but not be limited to, written, standardized procedures or protocols for the 244 dispensing of emergency contraception by a licensed pharmacist. Notwithstanding any general or 245 special law to the contrary, the commissioner, or a physician designated by the commissioner 246 who is registered to distribute or dispense a controlled substance in the course of professional 14 of 31 247 practice pursuant to section 7, shall issue a statewide standing order that may be used by a 248 licensed pharmacist to dispense emergency contraception under this section. 249 (c) Notwithstanding any general or special law to the contrary, a licensed pharmacist may 250 dispense emergency contraception in accordance with the statewide standing order issued under 251 subsection (b). Except for an act of gross negligence or willful misconduct, a pharmacist who, 252 acting in good faith, dispenses emergency contraception shall not be subject to any criminal or 253 civil liability or any professional disciplinary action by the board of registration in pharmacy 254 related to the use or administration of emergency contraception. 255 (d) Before dispensing emergency contraception authorized under this section, a 256 pharmacist may complete a training program approved by the commissioner on emergency 257 contraception; provided, however, that the training shall include, but not be limited to, proper 258 documentation, quality assurance and referral to additional services, including appropriate 259 recommendation that the patient follow-up with a medical practitioner. 260 (e) A pharmacist dispensing emergency contraception under this section shall annually 261 provide to the department the number of times such emergency contraception is dispensed. 262 Reports made pursuant to this section shall not identify any individual patient, shall be 263 confidential and shall not be public records as defined by clause Twenty-sixth of section 7 of 264 chapter 4 or section 10 of chapter 66. 265 (f) Except for an act of gross negligence or willful misconduct, the commissioner or a 266 physician who issues the statewide standing order under subsection (b) and any medical 267 practitioner who, acting in good faith, directly or through the standing order, prescribes or 15 of 31 268 dispenses emergency contraception shall not be subject to any criminal or civil liability or any 269 professional disciplinary action. 270 (g) The department, board of registration in medicine, board of registration in nursing and 271 board of registration in pharmacy shall adopt regulations to implement this section. 272 SECTION 10. Chapter 112 of the General Laws is hereby amended by inserting after 273 section 5F the following section:- 274 Section 5F½. Notwithstanding any general or special law to the contrary, no person shall 275 be subject to discipline by the board, including the revocation, suspension or cancellation of the 276 certificate of registration or reprimand, censure or monetary fine, for providing or assisting in the 277 provision of reproductive health care services or gender-affirming health care services, as those 278 terms are defined in section 11I½ of chapter 12, or for any judgment, discipline or other sanction 279 arising from such health care services if the services as provided would have been lawful and 280 consistent with good medical practice if they occurred entirely in the commonwealth. 281 The board shall not make available for public dissemination on a physician’s individual 282 profile the record of any criminal conviction or charge for a felony or serious misdemeanor, final 283 disciplinary action by a licensing board in another state or a medical malpractice court judgment, 284 arbitration award or settlement that resulted from providing or assisting in the provision of 285 reproductive health care services or gender-affirming health care services or for any judgment, 286 discipline or other sanction arising from such health care services if the services as provided 287 would have been lawful and consistent with good medical practice if they occurred entirely in 288 the commonwealth. The board shall not take adverse action on an application for registration of a 289 qualified physician based on a criminal or civil action, disciplinary action by a licensing board of 16 of 31 290 another state or a medical malpractice claim in another state arising from the provision of 291 reproductive health care services or gender-affirming health care services that, as provided, 292 would have been lawful and consistent with good medical practice if they occurred entirely in 293 the commonwealth. 294 Nothing in this section shall be construed to regulate the practice of medicine in any other 295 state. 296 SECTION 11. Section 9H of said chapter 112, as appearing in the 2020 Official Edition, 297 is hereby amended by inserting after the word “sections”, in line 4, the following words:- ; 298 provided, however, that notwithstanding any general or special law to the contrary, no person 299 shall be subject to discipline by the board, including the revocation, suspension or cancellation of 300 the certificate of registration or reprimand, censure or monetary fine, for providing or assisting in 301 the provision of reproductive health care services or gender-affirming health care services, as 302 those terms are defined in section 11I½ of chapter 12, or for any judgment, discipline or other 303 sanction arising from such health care services if the services as provided would have been 304 lawful and consistent with the standards of conduct for physician assistants if they occurred 305 entirely in the commonwealth; provided further, that the board shall not take adverse action on 306 an application for registration of a qualified physician assistant based on a criminal or civil 307 action or disciplinary action by a licensing board of another state that arises from such health 308 care services that, as provided, would have been lawful and consistent with the standards of 309 conduct for physician assistants if they occurred entirely in the commonwealth. 310 Nothing in this section shall be construed to regulate the practice of physician assistants 311 in any other state. 17 of 31 312 SECTION 12. Chapter 112 is hereby amended by striking out section 12N and inserting 313 in place thereof of the following section:- 314 Section 12N. If a pregnancy has existed for 24 weeks or more, no abortion may be 315 performed except by a physician, and only if in the best medical judgement of the physician it is: 316 (i) necessary to preserve the life of the patient; (ii) necessary to preserve the patient’s physical or 317 mental health; (iii) warranted because of a lethal fetal anomaly or diagnosis; or (iv) warranted 318 because of a grave fetal diagnosis that indicates that the fetus is incompatible with sustained life 319 outside of the uterus without extraordinary medical interventions. 320 SECTION 13. Said chapter 112 is hereby further amended by inserting after section 12N 321 the following section:- 322 Section 12N½. (a) Each circumstance permitting an abortion for a pregnancy that has 323 existed for 24 weeks or more under section 12N shall be considered independently by a treating 324 physician and a patient or the patient’s health care proxy. No medical review process shall 325 override a determination by a treating physician and a patient or the patient’s health care proxy to 326 provide an abortion consistent with said section 12N. 327 (b) Annually, not later than September 1, every facility authorized to perform health care 328 services under section 12N shall submit to the department of public health a written report that 329 includes the facility’s procedures and processes for providing services consistent with said 330 section 12N and this section. 331 SECTION 14. Section 32 of said chapter 112, as appearing in the 2020 Official Edition, 332 is hereby amended by striking out, in lines 6 and 7, the words “one hundred and thirty-eight” and 333 inserting in place thereof the following words:- 138; provided, however, that notwithstanding 18 of 31 334 any general or special law to the contrary, no person, pharmacy or pharmacy department shall be 335 subject to discipline by the board, including the revocation, suspension or cancellation of the 336 certificate of registration or reprimand, censure or monetary fine, for providing or assisting, 337 including dispensing of medication, in the provision of reproductive health care services or 338 gender-affirming health care services, as those terms are defined in section 11I½ of chapter 12, 339 or for any judgment, discipline or other sanction arising from such health care services if the 340 services as provided would have been lawful and consistent with the code of professional 341 conduct for pharmacists if they occurred entirely in the commonwealth; provided further, that the 342 board shall not take adverse action on an application for registration of a qualified pharmacist 343 based on a criminal or civil action or disciplinary action by a licensing board of another state that 344 arises from such health care services, including the dispensing of medication, that, as provided, 345 would have been lawful and consistent with the code of professional conduct for pharmacists if 346 they occurred entirely in the commonwealth. 347 Nothing in this section shall be construed to regulate the practice of pharmacists in any 348 other state. 349 SECTION 15. Section 77 of said chapter 112, as so appearing, is hereby amended by 350 adding the following 4 paragraphs:- 351 Notwithstanding any general or special law to the contrary, no person shall be subject to 352 discipline by the board, including the revocation, suspension or cancellation of the certificate of 353 registration or reprimand, censure or monetary fine, for providing or assisting in the provision of 354 reproductive health care services or gender-affirming health care services, as those terms are 355 defined in section 11I½ of chapter 12, or for any judgment, discipline or other sanction arising 19 of 31 356 from such health care services if the services as provided would have been lawful and consistent 357 with the standard of conduct for nurses if they occurred entirely in the commonwealth. 358 The board shall not make available for public dissemination on an advanced practice 359 registered nurse's individual profile the record of any criminal conviction or charge for a felony 360 or serious misdemeanor, final disciplinary action by a licensing board in another state or a 361 malpractice court judgment, arbitration award or settlement that resulted from providing or 362 assisting in the provision of reproductive health care services or gender-affirming health care 363 services or for any judgment, discipline or other sanction arising from such health care services if 364 the services as provided would have been lawful and consistent with the scope and standards of 365 advanced practice registered nursing practice if they occurred entirely in the commonwealth. 366 The board shall not take adverse action on an application for registration of a qualified 367 nurse based on a criminal or civil action or disciplinary action by a licensing board of another 368 state or a medical malpractice claim in another state arising from such health care services that, 369 as provided, would have been lawful and consistent with the standard of conduct for nurses if 370 they occurred entirely in the commonwealth. 371 Nothing in this section shall be construed to regulate the practice of nursing in any other 372 state. 373 SECTION 16. Section 128 of said chapter 112, as so appearing, is hereby amended by 374 inserting after the word “inclusive”, in line 4, the following words:- ; provided, however, that 375 notwithstanding any general or special law to the contrary, no person shall be subject to 376 discipline by the board, including the revocation, suspension or cancellation of the certificate of 377 registration or reprimand, censure or monetary fine, for providing or assisting in the provision of 20 of 31 378 reproductive health care services or gender-affirming health care services, as those terms are 379 defined in section 11I½ of chapter 12, or for any judgment, discipline or other sanction arising 380 from such health care services if the services as provided would have been lawful and consistent 381 with the standard of conduct adopted by the board by regulation if they occurred entirely in the 382 commonwealth; provided further, that the board shall not take adverse action on an application 383 for registration of a qualified psychologist based on a criminal or civil action or disciplinary 384 action by a licensing board of another state that arises from such health care services that, as 385 provided, would have been lawful and consistent with the standard of conduct adopted by the 386 board by regulation if they occurred entirely in the commonwealth. 387 Nothing in this section shall be construed to regulate the practice of psychology in any 388 other state. 389 SECTION 17. Section 137 of said chapter 112, as so appearing, is hereby amended by 390 inserting after the word “practice”, in line 8, the following words:- ; provided, however, that 391 notwithstanding any general or special law to the contrary, no person shall be subject to 392 discipline by the board, including the revocation, suspension or cancellation of the certificate of 393 registration or reprimand, censure or monetary fine, for providing or assisting in the provision of 394 reproductive health care services or gender-affirming health care services, as those terms are 395 defined in section 11I½ of chapter 12, or for any judgment, discipline or other sanction arising 396 from such health care services if the services as provided would have been lawful and consistent 397 with the standards of professional practice and conduct for social workers if they occurred 398 entirely in the commonwealth; provided further, that the board shall not take adverse action on 399 an application for registration of a qualified social worker based on a criminal or civil action or 400 disciplinary action by a licensing board of another state that arises from such health care services 21 of 31 401 that, as provided, would have been lawful and consistent with the standards of professional 402 practice and conduct for social workers if they occurred entirely in the commonwealth. 403 Nothing in this section shall be construed to regulate the practice of social work in any 404 other state. 405 SECTION 18. Section 10A of chapter 118E of the General Laws, as so appearing, is 406 hereby amended by inserting after the words “coverage for”, in line 1, the following words:- 407 abortion, as defined in section 12K of chapter 112, abortion-related care,. 408 SECTION 19. Said section 10A of said chapter 118E, as so appearing, is hereby further 409 amended by adding the following paragraph:- 410 Coverage provided under this section shall not be subject to any deductible, coinsurance, 411 copayment or any other cost-sharing requirement. Coverage offered under this section shall not 412 impose unreasonable restrictions or delays in the coverage. 413 SECTION 20. Chapter 147 of the General Laws is hereby amended by adding the 414 following section:- 415 Section 63. (a) As used in this section, the following words shall have the following 416 meanings unless the context clearly requires otherwise: 417 “Law enforcement agency of the commonwealth”, any state, municipal, college or 418 university police department, sheriff’s department, correctional facility, prosecutorial office, 419 court, probation office, or a program of more than 1 of any such entity, or any other non-federal 420 entity in the commonwealth charged with the enforcement of laws or the custody of detained 421 persons. 22 of 31 422 (b) Notwithstanding any general or special law to the contrary and except as required by 423 federal law, no officer or employee of a law enforcement agency of the commonwealth, while 424 acting under color of law, shall provide information or assistance to a federal law enforcement 425 agency or any other state’s law enforcement agency or any private citizen or quasi-law 426 enforcement agent in relation to an investigation or inquiry into services constituting legally- 427 protected health care activity, as defined in section 11I½ of chapter 12, if such services would be 428 lawful as provided if they occurred entirely in the commonwealth. 429 SECTION 21. Section 47F of chapter 175 of the General Laws, as appearing in the 2020 430 Official Edition, is hereby amended by inserting after the word “of”, in line 20, the following 431 words:- abortion, as defined in section 12K of chapter 112, abortion-related care,. 432 SECTION 22. Said section 47F of said chapter 175, as so appearing, is hereby further 433 amended by inserting after the third paragraph the following 3 paragraphs:- 434 Coverage provided under this section for abortion or abortion-related care shall not be 435 subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; 436 provided, however, that deductibles, coinsurance or copayments shall be required if the 437 applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt 438 status as a result of the prohibition on deductibles, coinsurance or copayments for these services. 439 Coverage offered under this section for abortion or abortion-related care shall not impose 440 unreasonable restrictions or delays in the coverage. 441 Benefits for an enrollee under this section shall be the same for the enrollee’s covered 442 spouse and covered dependents. 23 of 31 443 A policy of accident and sickness insurance that is purchased by an employer that is a 444 church or qualified church-controlled organization, as those terms are defined in subsection (j) of 445 section 47W, shall be exempt from covering abortion or abortion-related care at the request of 446 the employer. An employer that invokes the exemption under this section shall provide written 447 notice to prospective enrollees prior to enrollment with the plan and such notice shall list the 448 health care methods and services for which the employer will not provide coverage for religious 449 reasons. 450 SECTION 23. Section 193U of said chapter 175, as so appearing, is hereby amended by 451 inserting after the word “specialty”, in line 14, the following words:- ; provided further, that no 452 medical malpractice insurer shall discriminate against a provider or adjust or otherwise calculate 453 a provider’s risk classification or premium charges on the basis that, applying the definitions of 454 section 11I½ of chapter 12: (i) the health care provider offers reproductive health care services or 455 gender-affirming health care services that are unlawful in another state; (ii) another state’s laws 456 create potential or actual liability for those services; or (iii) abusive litigation against a provider 457 concerning reproductive health care services or gender-affirming health care services resulted in 458 a judgment against the provider, if such health care services would be lawful and consistent with 459 good medical practice as provided if they occurred entirely in the commonwealth. 460 SECTION 24. Section 8H of chapter 176A of the General Laws, as so appearing, is 461 hereby amended by inserting after the words “expense for”, in line 8, the following words:- 462 abortion, as defined in section 12K of chapter 112, abortion-related care,. 24 of 31 463 SECTION 25. Said section 8H of said chapter 176A, as so appearing, is hereby further 464 amended by striking out, in lines 9 and 10, the words “to the same extent that benefits are 465 provided for medical conditions not related to pregnancy”. 466 SECTION 26. Said section 8H of said chapter 176A, as so appearing, is hereby further 467 amended by inserting after the third paragraph the following 3 paragraphs:- 468 Coverage provided under this section for abortion or abortion-related care shall not be 469 subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; 470 provided, however, that deductibles, coinsurance or copayments shall be required if the 471 applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt 472 status as a result of the prohibition on deductibles, coinsurance or copayments for these services. 473 Coverage offered under this section for abortion or abortion-related care shall not impose 474 unreasonable restrictions or delays in the coverage. 475 Benefits for an enrollee under this section shall be the same for the enrollee’s covered 476 spouse and covered dependents. 477 A policy of accident and sickness insurance that is purchased by an employer that is a 478 church or qualified church-controlled organization, as those terms are defined in subsection (j) of 479 section 8W, shall be exempt from covering abortion or abortion-related care at the request of the 480 employer. An employer that invokes the exemption under this subsection shall provide written 481 notice to prospective enrollees prior to enrollment with the plan and such notice shall list the 482 health care methods and services for which the employer will not provide coverage for religious 483 reasons. 25 of 31 484 SECTION 27. Section 4H of chapter 176B of the General Laws, as so appearing, is 485 hereby amended by inserting after the words “expense for”, in lines 7 and 8, the following 486 words:- abortion, as defined in section 12K of chapter 112, abortion-related care,. 487 SECTION 28. Said section 4H of said chapter 176B, as so appearing, is hereby further 488 amended by striking out, in lines 8 to 10, inclusive, the words “to the same extent that benefits 489 are provided for medical conditions not related to pregnancy”. 490 SECTION 29. Said section 4H of said chapter 176B, as so appearing, is hereby further 491 amended by inserting after the third paragraph the following 3 paragraphs:- 492 Coverage provided under this section for abortion or abortion-related care shall not be 493 subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; 494 provided, however, that deductibles, coinsurance or copayments shall be required if the 495 applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt 496 status as a result of the prohibition on deductibles, coinsurance or copayments for these services. 497 Coverage offered under this section for abortion or abortion-related care shall not impose 498 unreasonable restrictions or delays in the coverage. 499 Benefits for an enrollee under this section shall be the same for the enrollee’s covered 500 spouse and covered dependents. 501 A policy of accident and sickness insurance that is purchased by an employer that is a 502 church or qualified church-controlled organization, as those terms are defined in subsection (j) of 503 section 4W, shall be exempt from covering abortion or abortion-related care at the request of the 504 employer. An employer that invokes the exemption under this subsection shall provide written 505 notice to prospective enrollees prior to enrollment with the plan and such notice shall list the 26 of 31 506 health care methods and services for which the employer will not provide coverage for religious 507 reasons. 508 SECTION 30. Section 4I of chapter 176G of the General Laws, as so appearing, is hereby 509 amended by inserting after the words “coverage for”, in lines 1 and 2, the following words:- 510 abortion, as defined in section 12K of chapter 112, abortion-related care,. 511 SECTION 31. Said section 4I of said chapter 176G, as so appearing, is hereby further 512 amended by inserting after the second paragraph the following 3 paragraphs:- 513 Coverage provided under this section for abortion or abortion-related care shall not be 514 subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; 515 provided, however, that deductibles, coinsurance or copayments shall be required if the 516 applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt 517 status as a result of the prohibition on deductibles, coinsurance or copayments for these services. 518 Coverage offered under this section for abortion or abortion-related care shall not impose 519 unreasonable restrictions or delays in the coverage. 520 Benefits for an enrollee under this section shall be the same for the enrollee’s covered 521 spouse and covered dependents. 522 A health maintenance contract that is purchased by an employer that is a church or 523 qualified church-controlled organization, as those terms are defined in subsection (j) of section 524 4O, shall be exempt from covering abortion or abortion-related care at the request of the 525 employer. An employer that invokes the exemption under this subsection shall provide written 526 notice to prospective enrollees prior to enrollment with the plan and such notice shall list the 27 of 31 527 health care methods and services for which the employer will not provide coverage for religious 528 reasons. 529 SECTION 32. Section 4A of chapter 218 of the General Laws, as so appearing, is hereby 530 amended by inserting after the word “filing”, in line 20, the following words:- ; provided further, 531 that, except as required by federal law, a judgment creditor shall not file a copy of any foreign 532 judgment under this section if the judgment was issued in connection with any litigation 533 concerning legally-protected health care activity, as defined in section 11I½ of chapter 12. 534 SECTION 33. Subsection (g) of said section 4A of said chapter 218, as so appearing, is 535 hereby amended by adding the following sentence:- In any action filed to enforce a judgment 536 issued in connection with any litigation concerning legally-protected health care activity, as 537 defined in section 11I½ of chapter 12, the court in the commonwealth hearing the action shall not 538 give any force or effect to any judgment issued without jurisdiction. 539 SECTION 34. Section 11 of chapter 223A of the General Laws, as so appearing, is 540 hereby amended by adding the following paragraph:- 541 Notwithstanding any other provision of this section to the contrary and except as required 542 by federal law, a court of this commonwealth shall not order a person who is domiciled or found 543 within this commonwealth to give testimony or statement or produce documents or other things 544 for use in connection with any proceeding in a tribunal outside the commonwealth concerning 545 legally-protected health care activity, as defined in section 11I½ of chapter 12. 546 SECTION 35. Section 59H of chapter 231 of the General Laws, as so appearing, is 547 hereby amended by inserting after the word “case”, in line 1, the following words:- , except a 548 case brought pursuant to section 11I½ of chapter 12,. 28 of 31 549 SECTION 36. Section 13A of chapter 233 of the General Laws, as so appearing, is 550 hereby amended by inserting after the word “summons”, in line 32, the following words:- , 551 except that no justice or special justice shall issue a summons in a case, except as required by 552 federal law, where prosecution is pending concerning legally-protected health care activity, as 553 defined in section 11I½ of chapter 12, or where a grand jury investigation concerning legally- 554 protected health care activity has commenced or is about to commence for a criminal violation of 555 a law of such other state unless the acts forming the basis of the prosecution or investigation 556 would also constitute an offense if occurring entirely in the commonwealth. 557 SECTION 37. Section 21A of chapter 272 of the General Laws, as so appearing, is 558 hereby amended by striking out the third paragraph and inserting in place thereof the following 559 paragraph:- This section shall not be construed to permit the sale or dispensing of prescription 560 drugs or devices for the prevention of pregnancy or conception by a vending machine or similar 561 device. 562 SECTION 38. Section 13 of chapter 276 of the General Laws, as so appearing, is hereby 563 amended by striking out the first paragraph and inserting in place thereof the following 2 564 paragraphs:- 565 The governor may also surrender, on demand of the executive authority of any other 566 state, any person in the commonwealth charged in such other state in the manner provided in 567 section 14 with committing an act in this commonwealth, or in a third state, intentionally 568 resulting in a crime in the state whose executive authority is making the demand, hereafter in this 569 section and in sections 14 to 20P, inclusive, referred to as the demanding state, only when the 570 acts for which extradition is sought would be punishable by the laws of the commonwealth if the 29 of 31 571 consequences claimed to have resulted therefrom in the demanding state had taken effect in this 572 commonwealth and the provisions of sections 11 to 20R, inclusive, not otherwise inconsistent 573 shall apply to such cases even though the accused was not in the demanding state at the time of 574 the commission of the crime and has not fled therefrom; provided, however, that the governor 575 may, in the governor’s discretion, make any such surrender conditional upon agreement by the 576 executive authority of the demanding state that the person so surrendered will be held to answer 577 no criminal charges of any nature except those set forth in the requisition upon which such 578 person is so surrendered, at least until such person has been given reasonable opportunity to 579 return to the commonwealth after the person’s acquittal, if the person shall be acquitted, or after 580 the person shall be released from confinement, if the person shall be convicted. 581 Except as required by federal law, the governor shall not surrender a person charged in 582 another state as a result of engaging in legally-protected health care activity, as defined in section 583 11I½ of chapter 12, unless the executive authority of the demanding state shall allege in writing 584 that the accused was physically present in the demanding state at the time of the commission of 585 the alleged offense and that thereafter the accused fled from the demanding state. 586 SECTION 39. Section 14 of said chapter 276, as so appearing, is hereby amended by 587 inserting the after word “state”, in line 7, the following words:- only when the acts for which the 588 demand for interstate rendition is sought would be punishable by the laws of the commonwealth, 589 if the consequences claimed to have resulted therefrom in the demanding state had taken effect in 590 this commonwealth. 30 of 31 591 SECTION 40. Section 20A of said chapter 276, as so appearing, is hereby amended by 592 inserting after the word “thirteen”, in lines 5 and 12 and 13, the following words:- , with the 593 exception of cases for which the governor shall not surrender a person under said section 13. 594 SECTION 41. Section 20B of said chapter 276, as so appearing, is hereby amended by 595 adding the following sentence:- This section shall not apply to cases arising under section 13 for 596 which the governor shall not surrender a person. 597 SECTION 42. Section 20C of said chapter 276, as so appearing, is hereby amended by 598 inserting after the word “thirteen”, in line 4, the following words:- , with the exception of cases 599 for which the governor shall not surrender a person under said section 13. 600 SECTION 43. Not later than April 1, 2023, the department of public health, in 601 consultation with Reproductive Equity Now, Inc., shall issue a report to the senate and house 602 committees on ways and means and the joint committee on public health identifying areas of the 603 commonwealth in which pregnant people do not have access to abortion, as defined in section 604 12K of chapter 112 of the General Laws, or birth care within a radius of 50 miles and providing 605 recommendations to facilitate access to abortion and birth care in the identified areas. The report 606 shall be made publicly available on the department’s website. 607 SECTION 44. Sections 7, 8, 18, 19, 21, 22 and 24 to 31, inclusive, shall apply to all 608 policies, contracts and certificates of health insurance subject to chapters 32A, 118E, 175, 176A, 609 176B and 176G of the General Laws that are delivered, issued or renewed on or after January 1, 610 2023. 31 of 31 611 SECTION 45. An institution, as defined in section 46 of chapter 15A of the General 612 Laws, shall not be required to utilize money from its general fund or student fees for medication 613 abortion readiness required under said section 46 of said chapter 15A until January 1, 2026. 614 SECTION 46. Each institution’s first medication abortion readiness plan as required 615 under subsection (b) of section 46 of chapter 15A of the General Laws shall be submitted to the 616 department of public health not later than November 30, 2023 and the department shall review 617 such plans for suitability by January 31, 2024. 618 SECTION 47. Subsections (c) and (d) of section 46 of chapter 15A of the General Laws 619 shall take effect on February 1, 2024.