Text of MA S 2522 (2025)

1 of 1 SENATE DOCKET, NO. 2808 FILED ON: 4/7/2025 SENATE . . . . . . . . . . . . . . No. 2522 The Commonwealth of Massachusetts _________________ PRESENTED BY: Cindy F. Friedman _________________ To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled: The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: An Act strengthening health care protections in the Commonwealth. _______________ PETITION OF: NAME: DISTRICT/ADDRESS: Cindy F. Friedman Fourth Middlesex Andrea Joy Campbell Attorney General Joanne M. Comerford Hampshire, Franklin and Worcester 4/14/2025 Julian Cyr Cape and Islands 4/14/2025 Jacob R. Oliveira Hampden, Hampshire and Worcester 4/14/2025 Rebecca L. Rausch Norfolk, Worcester and Middlesex 4/17/2025 Carmine Lawrence Gentile 13th Middlesex 5/19/2025 Erika Uyterhoeven 27th Middlesex 5/20/2025 David M. Rogers 24th Middlesex 5/20/2025 Pavel M. Payano First Essex 5/27/2025 1 of 16 SENATE DOCKET, NO. 2808 FILED ON: 4/7/2025 SENATE . . . . . . . . . . . . . . No. 2522 By Ms. Friedman, a petition (accompanied by bill) (subject to Joint Rule 12) of Cindy F. Friedman and Andrea Joy Campbell, Attorney General for legislation to strengthen health care protections in the Commonwealth. Health Care Financing. The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Fourth General Court (2025-2026) _______________ An Act strengthening health care protections in the Commonwealth. 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 7 of chapter 4 of the General Laws, as appearing in the 2022 2 Official Edition, is hereby amended by inserting at the end of the twenty-sixth clause the 3 following subsection:- 4 (w) the name, home address, personal email address, telephone number, and any other 5 personal information of an individual engaged in the provision, facilitation, or promotion of 6 reproductive health care services or gender-affirming health care services, as defined in section 7 11I½ of chapter 12. 8 SECTION 2. Section 11I ½ of chapter 12 of the General Laws, as appearing in the 2022 9 Official Edition, is hereby amended by inserting after subsection (f) the following 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 2 of 16 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 time, money, 16 facilities, property, equipment, personnel, or other resources in relation to an investigation or 17 inquiry into services constituting legally-protected health care activity, as defined in section 18 11I½ of this chapter 12, if such services would be lawful as provided if they occurred entirely in 19 the commonwealth. 20 (h) Evidence relating to the involvement of an individual in one or more legally-protected 21 health care activity, as defined in section 11I ½ of this chapter, shall not be offered against such 22 individual as evidence that such party has engaged in any wrongdoing, whether civil, criminal, 23 professional, or otherwise by virtue individual who received of such services not being 24 physically present in the commonwealth when they received such services. Nothing in this 25 section shall prevent a party from offering such evidence in a proceeding that (i) sounds in tort or 26 contract; (ii) is actionable, in an equivalent or similar manner, under the laws of the 27 commonwealth; and (iii) was brought by the patient who received reproductive health care 28 services or gender-affirming health care services, or the patient’s legal representative. 29 (i) The attorney general may bring a civil action for injunctive or other equitable relief to 30 enforce the provisions of this section. 31 SECTION 3. Section 12 of chapter 12C of the General Laws, as appearing in the 2022 32 Official Edition, is hereby amended by inserting after subsection (b) the following subsection:- 33 (c) Except as required by federal law, the center shall not provide access to any data, 34 including de-identified data or any other data that would allow the identification of health 3 of 16 35 information of a patient or provider in response to an out-of-state or federal inquiry or 36 investigation into services constituting legally protected health care activity, as defined in section 37 11I½ of chapter 12. 38 SECTION 4. Section 10B of chapter 66 of the General Laws, as appearing in the 2022 39 Official Edition, is hereby amended by striking out, in line 20, the words “persons providing or 40 training in family planning services,” and inserting in place thereof the following words:- 41 persons engaged in the provision, facilitation, or promotion of reproductive health care services 42 or gender-affirming health care services, as defined in section 11I½ of chapter 12, 43 SECTION 5. Section 75 of chapter 31 of the General Laws, as appearing in the 2022 44 Official Edition, as amended by chapter 238 of the acts of 2024, is hereby further amended by 45 adding the following paragraph:- 46 Nothing in this section shall be construed to permit civil service employees to furnish 47 information to, or cooperate with, law enforcement authorities in contravention of Section 11I½ 48 of Chapter 12, Section 63 of Chapter 147. 49 SECTION 6. Chapter 93 of the General Laws is hereby amended by adding after section 50 114 the following section:- 51 Section 115. Out-of-state warrants or subpoenas for legally protected health care 52 information 53 (a) For the purposes of this section, the following terms shall have the following 54 meanings: 4 of 16 55 (1) “Electronic communication” means any transfer of signs, signals, writing, images, 56 sounds, data, or intelligence of any nature transmitted in whole or in part by a wire, radio, 57 electromagnetic, photoelectronic or photo-optical system; provided, however, such term shall not 58 include: (i) any communication made through a tone only paging device; (ii) any communication 59 made through a tracking device consisting of an electronic or mechanical device which permits 60 the tracking of the movement of a person or object; or (iii) any communication that is 61 disseminated by the sender through a method of transmission that is configured so that such 62 communication is readily accessible to the public. 63 (2) “Electronic communication services” means any service which provides to users 64 thereof the ability to send or receive wire or electronic communications. 65 (3) “Prohibited violation” means any civil or criminal offense defined under the laws of 66 another state that creates civil or criminal liability for legally protected health care activity as 67 defined in section 11I ½ of chapter 12. 68 (b) A business entity that operates in Massachusetts and provides electronic 69 communication services or remote computing services to Massachusetts residents or business 70 entities organized under the laws of the commonwealth of Massachusetts may not: 71 (1) Comply with a subpoena, warrant, other civil or criminal legal process for records, 72 information, or assistance that the business entity knows relates to a Massachusetts resident, 73 Massachusetts health care provider, or Massachusetts business entity in connection with legally 74 protected health care activity, as defined in section 11I ½ of chapter 12, except as required by a 75 valid federal law, unless the subpoena, warrant, or other civil or criminal legal process includes, 76 or is accompanied by, an attestation, made under penalty of perjury, stating that the subpoena, 5 of 16 77 warrant, or other civil or criminal legal process does not seek documents, information, or 78 testimony relating to an investigation into, or the enforcement of, another state’s law that asserts 79 criminal or civil liability for the provision, receipt, attempted provision or receipt, assistance in 80 the provision or receipt, or attempted assistance in the provision or receipt of legally- protected 81 health care activity that is lawful in the commonwealth of Massachusetts. 82 (2) Any false attestation submitted under this section is subject to a statutory penalty of 83 not more than $50,000 per violation. Submission of such attestation subjects the attester to the 84 jurisdiction of the courts of Massachusetts for any suit, penalty, or damages arising out of a false 85 attestation under this section. 86 (3) The attorney general may commence a civil action to compel any business entity that 87 operates in Massachusetts and that provides electronic communications services or remote 88 computing services to Massachusetts residents to comply with the provisions of this section. 89 SECTION 7. Section 21 of chapter 94C of the General Laws, as appearing in the 2022 90 Official Edition, is hereby amended by inserting after the first paragraph the following 91 paragraph:- 92 Except as required by federal law, the label for a controlled substance prescribed for 93 “reproductive health care services” or “gender-affirming health care services,” as defined in 94 section 11I½ of chapter 12, shall, at the request of the provider, include the name of the 95 prescribing health care practice instead of the name of the practitioner. 96 SECTION 8. Section 22 of said chapter 94C, as so appearing, is hereby amended by 97 adding the following after subsection (c)the following subsection:- 6 of 16 98 (d) Notwithstanding subsection (b) and to the extent allowable under federal law, the 99 label for a controlled substance prescribed for “reproductive health care services” or “gender- 100 affirming health care services,” as defined in section 11I½ of chapter 12 , may include the name 101 of the dispensing health care practice instead of the name of the dispensing practitioner. 102 SECTION 9. Section 24A of said chapter 94C, as so appearing, is hereby amended by 103 adding the following sentence at the end of subsection (a)(1):- 104 Notwithstanding the other provisions of this section, medications specifically prescribed 105 for reproductive health care services and gender-affirming health care services as defined in 106 section 11I ½ of chapter 12, shall be excluded from this electronic monitoring program unless 107 reporting of such is determined by the department to be necessary to protect the public health. 108 SECTION 10. Section 24A of said chapter 94C, as so appearing, is hereby further 109 amended by adding the following subsection:- 110 (n) Notwithstanding any general or special law to the contrary, except as required by 111 federal law, the department shall not provide disaggregated data or individually identifiable data 112 from the prescription drug monitoring program to a federal law enforcement agency or other 113 agency, or any other state or local law enforcement agency or other agency, or any private citizen 114 or entity or quasi-law enforcement agent in relation to an investigation or inquiry into 115 reproductive health care services or gender-affirming health care services, as defined in section 116 11I½ of chapter 12, if such services would be lawful as provided if they occurred entirely in the 117 commonwealth. This section shall not be construed to apply to prescription drugs for usages, 118 including off-label usages, that are unrelated to reproductive health care services or gender- 119 affirming health care services. 7 of 16 120 SECTION 11. Chapter 111 of the General Laws is hereby amended by adding after 121 section 51 the following section:- 122 Section 51¼. Emergency medical treatment 123 (a) For purposes of this section the following words shall have the following meaning, 124 unless the context clearly requires otherwise:- 125 “Emergency medical condition”, a medical condition manifesting itself by acute 126 symptoms of sufficient severity such that the absence of immediate medical attention could 127 reasonably be expected to result in: (i) placing the health of the applicant in serious jeopardy; (ii) 128 serious impairment of bodily functions; or (iii) serious dysfunction of any bodily organ or part. 129 Such conditions include, but are not limited to, when a pregnant patient is experiencing ectopic 130 pregnancy, complications of pregnancy loss or abortion, risks to future fertility, preterm 131 premature rupture of membranes (PPROM), placental abruption or bleeding from placenta previa 132 or emergent hypertensive disorders, such as preeclampsia and eclampsia, and peripartum 133 cardiomyopathy. 134 “Stabilizing treatment”, includes abortion when abortion is necessary to resolve the 135 applicant’s injury or emergency medical condition. 136 (b) All acute-care hospitals licensed under section 51G of chapter 111, during all 137 operating hours of an emergency department or a satellite emergency facility as defined in 138 section 51½ of chapter 111, shall provide hospital emergency services to any applicant who 139 applies for the same in case of injury or an emergency medical condition. For purposes of this 140 section, “applicant” includes any person who presents at the hospital or who is brought to a 141 hospital by ambulance or specialized emergency medical services vehicle as defined in section 1 8 of 16 142 of chapter 111C. Hospitals shall furnish hospital emergency services including but not limited to, 143 medical screening by qualified medical personnel to reach with reasonable clinical confidence a 144 determination of whether an applicant has an emergency medical condition, and the provision of 145 necessary stabilizing treatment for applicants with an emergency medical condition. Hospitals 146 shall further establish and maintain policies and procedures for the provision of hospital 147 emergency services, including for an applicant’s refusal to consent, restricting transfers until the 148 applicant is stabilized, appropriate transfers of applicants, nondiscrimination, no delay in 149 examination or treatment, and whistleblower protections. 150 (c) The department shall have the authority to promulgate such regulations as may be 151 necessary to implement the provisions of this section. 152 (d) The attorney general may bring a civil action for injunctive or other equitable relief to 153 enforce the provisions of this section. In any action brought by the attorney general under this 154 section, the court may also award a civil penalty of not more than ten thousand dollars for each 155 violation. 156 SECTION 12. Said chapter 111 is hereby amended by adding after section 70H the 157 following section:- 158 Section 70I. Prohibiting disclosure of legally protected health care information 159 (a) For the purposes of this section, the term “business” shall mean: 160 (1) Any business organized for the purpose of maintaining medical information in order 161 to make an individual’s medical information available to an individual or to a provider of health 162 care at the request of the individual or a provider of health care, for purposes of allowing the 9 of 16 163 individual to manage the individual’s medical information, or for the diagnosis and treatment of 164 the individual; or 165 (2) Any business that offers medical recordkeeping, electronic health record, or electronic 166 medical record services, including, but not limited to software or hardware to consumers that 167 makes an individual’s medical information available to an individual or a provider of health care 168 at the request of the individual or a provider of health care, for purposes of allowing the 169 individual to manage the individual’s medical information, or for the diagnosis, treatment, or 170 management of a medical condition of the individual; or 171 (3) Any business that is licensed by the department of public health or the department of 172 mental health to provide medical, clinical, behavioral, or health services; or 173 (4) Any business that offers a digital service to a consumer for the purpose of allowing 174 the individual to manage the individual’s reproductive or sexual health information, or for the 175 diagnosis, treatment, or management of a reproductive or sexual health medical condition of the 176 individual. 177 (b) A business, as described in subsection (a), that electronically stores or maintains 178 medical information related to the provision of abortion or abortion-related health care services, 179 miscarriage management, in vitro fertilization, and gender-affirming health care services, 180 including, but not limited to, on an electronic health record system or electronic medical record 181 system, on behalf of a provider of health care, health care insurance plan, pharmaceutical 182 company, contractor, or employer, shall develop capabilities, policies and procedures to enable, 183 and shall enable, all of the following: 10 of 16 184 (1) Limit user access privileges to information systems that contain medical information 185 related to abortion or abortion-related health care services, miscarriage management, in vitro 186 fertilization, and gender-affirming health care services only to those persons who are authorized 187 in writing by the patient to access specified medical information. 188 (2) Prevent the disclosure, access, transfer, transmission, or processing of medical 189 information related to abortion or abortion-related health care services, miscarriage management, 190 in vitro fertilization, or gender-affirming health care services to persons and entities outside of 191 this commonwealth, absent the express written consent of the patient, independent of any other 192 agreement, that specifically authorizes the disclosure, access, transfer, transmission, or 193 processing of medical information to the named persons or entities outside of this 194 commonwealth. 195 (3) Automatically disable access by individuals and entities outside this commonwealth 196 to segregated medical information related to abortion or abortion-related health care services, 197 miscarriage management, in vitro fertilization, or gender-affirming health care services, absent 198 the express written consent of the patient that specifically authorizes access by named persons or 199 entities outside of this commonwealth to such segregated medical information 200 (c) The department of public health shall have the authority to promulgate such 201 regulations for licensed providers and entities as may be necessary to implement the provisions 202 of this section. 203 (d) The department of public health shall promulgate a consent form that meets the 204 requirements of this section and require its use by all licensed health care providers in the 205 commonwealth. 11 of 16 206 (e) The attorney general may bring a civil action for injunctive or other equitable relief to 207 enforce the provisions of this section. In any action brought by the attorney general under this 208 section, the court may also award a civil penalty of not more than five thousand dollars for each 209 violation. 210 SECTION 13. Section 12Q of chapter 112 of the General Laws, as appearing in the 2022 211 Official Edition, is hereby amended by adding the following paragraph:- 212 The commissioner of public health shall not, pursuant to this section, collect, maintain, 213 use, disclose, or disseminate disaggregated surveillance data or individually identifiable 214 surveillance data on abortions performed in the commonwealth. The name, home address, 215 personal email address, and telephone number of individuals engaged in the provision, 216 facilitation, or promotion of reproductive health care services, as defined in section 11I½ of 217 chapter 12, shall not be considered a public record under chapter 66 of the general laws. 218 SECTION 14. Said chapter 112 is hereby further amended by adding after section 12Q 219 the following section:- 220 Section 12Q½. Collection of data on gender-affirming health care 221 The commissioner of public health shall not collect, maintain, or use individually 222 identifiable data on gender-affirming health care services provided in the commonwealth, as 223 defined in section 11I ½ of chapter 12, except as authorized by law, and shall not disclose, or 224 disseminate disaggregated data or individually identifiable surveillance data on gender-affirming 225 health care services, as defined in section 11I ½ of chapter 12, provided in the commonwealth. 226 The name, home address, personal email address, and telephone number of individuals engaged 227 in the provision, facilitation, or promotion of gender-affirming health care services, as defined in 12 of 16 228 section 11I½ of chapter 12, shall not be considered a public record under chapter 66 of the 229 general laws. 230 SECTION 15. Section 61 of said chapter 112, as so appearing, is hereby further amended 231 by adding the following paragraphs:- 232 Notwithstanding any general or special law to the contrary, no person shall be subject to 233 discipline by the boards, including the revocation, suspension or cancellation of the certificate of 234 registration or license or reprimand, censure or monetary fine, for providing or assisting in the 235 provision of reproductive health care services or gender-affirming health care services, as those 236 terms are defined in section 11I½ of chapter 12, or for any judgment, discipline or other sanction 237 arising from such health care services if the services as provided would have been lawful and 238 consistent with the standard of conduct for the designated profession if they occurred entirely in 239 the commonwealth. 240 The boards shall not make available for public dissemination on an individual’s profile 241 the record of any criminal conviction or charge for a felony or serious misdemeanor, final 242 disciplinary action by a licensing board in another state or a malpractice court judgment, 243 arbitration award or settlement that resulted from providing or assisting in the provision of 244 reproductive health care services or gender-affirming health care services or for any judgment, 245 discipline or other sanction arising from such health care services if the services as provided 246 would have been lawful and consistent with the scope and standards of practice for the 247 designated profession if they occurred entirely in the commonwealth. 248 The boards shall not take adverse action on an application for registration or licensure 249 based on a criminal or civil action or disciplinary action by a licensing board of another state or a 13 of 16 250 medical malpractice claim in another state arising from such health care services that, as 251 provided, would have been lawful and consistent with the standard of conduct for the designated 252 profession if they occurred entirely in the commonwealth. 253 SECTION 16. Section 63 of chapter 147 of the General Laws, as appearing in the 2022 254 Official Edition, is hereby amended by striking out subsection (b) and inserting in place thereof 255 the following subsections:- 256 (b) Notwithstanding any general or special law to the contrary and except as required by 257 federal law, no state or local law enforcement agency or officer or employee or any other person 258 acting on behalf of a state or local law enforcement agency of the commonwealth, while acting 259 under color of law, shall provide information or assistance to a federal law enforcement agency 260 or any other state’s agency, including a law enforcement agency, or any private citizen or quasi- 261 law enforcement agent, or expend or use time, money, facilities, property, equipment, personnel, 262 or other resources in relation to an investigation or inquiry into services constituting legally- 263 protected health care activity, as defined in section 11I½ of chapter 12, if such services would be 264 lawful as provided if they occurred entirely in the commonwealth. 265 (c) The attorney general may bring a civil action for injunctive or other equitable relief to 266 enforce the provisions of this section. 267 SECTION 17. Chapter 175 of the General Laws is hereby amended by adding after 268 section 193U the following section:- 269 Section 193V. Discrimination on the basis of legally protected health care activity 14 of 16 270 No insurance company offering for sale any policy of insurance shall discriminate against 271 a nonprofit charitable organization, including those corporations qualified under 26 USC section 272 501(c)(3), or adjust or otherwise calculate such nonprofit charitable organization’s risk 273 classification or premium charges in the provision of any form of liability insurance covering 274 negligence, wrongful acts, errors or omissions of the organization and its respective members, 275 directors and officers, on the basis that, applying the definitions of section 11I½ of chapter 12: (i) 276 the organization offers reproductive health care services or gender-affirming health care services; 277 (ii) the organization engages in legally-protected health care activity; or (iii) the organization is 278 or may be the subject of abusive litigation. 279 SECTION 18. Chapter 209B of the General Laws is hereby amended by adding after 280 section 14 the following section:- 281 Section 15. Other state bans on gender-affirming health care for minors 282 (a) A law of a jurisdiction outside the commonwealth that authorizes a child to be 283 removed from the care or custody parent or guardian based on the parent or guardian allowing 284 their child to receive gender-affirming care health care services, as defined in section 11I½ of 285 chapter 12, or that bans the provision of gender-affirming care, shall not provide a basis to alter 286 custody, parenting, time, or visitation, or to make a finding of abuse, neglect or maltreatment, in 287 a case pending in a court in the commonwealth, unless conduct under such law would constitute 288 abuse, neglect or maltreatment under the laws of the commonwealth. 289 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 290 maltreatment based on the parent or guardian allowing their child to receive or seek gender- 291 affirming health care services, or a finding that a parent or guardian is criminally, civilly, or 15 of 16 292 otherwise liable for violating another’s state’s law that bans the provision of gender-affirming 293 health care, as defined in section 11I ½ of chapter 12, as evidence in any proceeding with respect 294 to that parent or guardian and any of their children, unless such conduct would constitute abuse, 295 neglect or maltreatment under the laws of the commonwealth. 296 SECTION 19. Chapter 221 of the General Laws is hereby amended by adding after 297 section 40 the following section:- 298 Section 40A. Removal or discipline of attorneys representing individuals engaged in 299 reproductive or gender-affirming health care 300 Notwithstanding any general or special law or rule or regulation to the contrary, no 301 attorney licensed in the commonwealth may be removed or otherwise subject to discipline, 302 including the revocation, suspension or cancellation of the attorney’s license or reprimand, 303 censure, or monetary fine, for advising or representing a client or prospective client related to the 304 provision of reproductive health care services or gender-affirming health care services, as 305 defined in section 11I ½ of chapter 12, if the sole reason for such removal or discipline is that: (i) 306 the client offered, provided, or received reproductive health care services or gender-affirming 307 health care services that are unlawful in another state, or (ii) another state’s laws creates actual or 308 potential liability for the reproductive health care services or gender-affirming health care 309 services offered, provided, or received by the client, or (iii) the attorney is subject to actual or 310 potential liability, or removal or discipline, in another jurisdiction based on the reproductive 311 health care services or gender-affirming health care services offered, provided, or received by the 312 client, so long as the attorney’s conduct otherwise complies with the laws of the commonwealth 16 of 16 313 and meets the standards set forth in the Rules of Professional Responsibility promulgated by the 314 Supreme Judicial Court. 315 SECTION 20. Subsection (b) of section 70I of chapter 111, as amended by section 10, 316 shall be implemented by businesses no later than July 1, 2026.