Text of MA S 2543 (2025)

1 of 21 FILED ON: 6/26/2025 SENATE . . . . . . . . . . . . . . No. 2543 Senate, June 26, 2025 -- Text of the Senate Bill strengthening health care protections in the Commonwealth (Senate, No. 2543) (being the text of Senate, No. 2538, printed as amended). 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. 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 2 of 21 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, 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 so appearing, is hereby 31 amended by striking out subsection (b) and inserting in place thereof the following:- 32 (b) The center shall permit a government agency or authority to access identifiable health 33 information of an individual only to the extent necessary for such government agency or 34 authority to accomplish the public purposes for which access was given, subject to subsection (f) 3 of 21 35 of this section. Except as required by federal law, the center shall not provide access to any data, 36 including de-identified data or any other data that would allow the identification of a patient or 37 provider in response to an out-of-state or federal inquiry or investigation into services 38 constituting legally protected health care activity, as defined in section 11I1/2 of chapter 12. 39 (c) The center shall permit providers, provider organizations and public and private 40 health care payers access to identifiable health information of an individual solely for the 41 purposes of carrying out treatment, payment, or health care operations. 42 (d) The center may disclose identifiable health information of an individual for research, 43 regardless of the source of funding of the research, provided that: (i) the center obtains 44 documentation of authorization from the individual patient; or (ii) waiver of individual 45 authorization has been approved by either an institutional review board or privacy board. 46 (e) The center may disclose de-identified health information of an individual for the 47 purposes of lowering total medical expenses, coordinating care, benchmarking, quality analysis, 48 research, administrative or planning purposes, informing consumer health care decisions, or 49 other purposes that aim to improve healthcare or public health outcomes for Commonwealth 50 residents that are consistent with the goals this chapter. A recipient of de-identified health 51 information of an individual shall not use such information or data to identify any person for any 52 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. 4 of 21 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. 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 this section, or any rule or regulation issued hereunder, shall constitute 63 a violation of chapter 93A. 64 SECTION 4. Section 75 of chapter 31 of the General Laws, as amended by chapter 238 65 of the acts of 2024, is hereby further 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 and 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 in the provision, facilitation or promotion of reproductive health care 73 services or gender-affirming health care services, as defined in section 11I1/2 of chapter 12. 74 SECTION 6. Chapter 93 of the General Laws is hereby amended by adding the following 75 section:- 76 Section 115. (a) As used in this section, the following terms shall have the following 77 meanings unless the context requires otherwise: 5 of 21 78 “Electronic communication”, any transfer of signs, signals, writing, images, sounds, data 79 or intelligence of any nature transmitted in whole or in part by a wire, radio, electromagnetic, 80 photoelectronic or photo-optical system; provided, however, such term shall not include: (i) any 81 communication made through a tone only paging device; or (ii) any communication that is 82 disseminated by the sender through a method of transmission that is configured so that such 83 communication is readily accessible to the public. 84 “Electronic communication services”, any service which provides to users thereof the 85 ability to send or receive wire or electronic communications. 86 “Prohibited violation”, any civil or criminal offense defined under the laws of another 87 state that creates civil or criminal liability for legally-protected health care activity as defined in 88 section 11I1/2 of chapter 12. 89 “Remote computing services”, as defined in 18 U.S.C. 2711. 90 (b) A business entity that operates in the commonwealth and provides electronic 91 communication services or remote computing services to residents of the commonwealth or 92 business entities organized under the laws of the commonwealth shall not comply with a 93 subpoena, warrant or other civil or criminal legal process for records, information or assistance 94 that the business entity knows relates to a resident, health care provider or business entity in the 95 commonwealth in connection with legally-protected health care activity as defined in section 96 11I½ of chapter 12, except as required by a valid federal law, unless the subpoena, warrant or 97 other civil or criminal legal process includes, or is accompanied by, an attestation, made under 98 penalty of perjury, stating that the subpoena, warrant or other civil or criminal legal process does 99 not seek documents, information or testimony relating to an investigation into, or the 6 of 21 100 enforcement of, another state’s law that asserts criminal or civil liability for the provision, 101 receipt, attempted provision or receipt, assistance in the provision or receipt or attempted 102 assistance in the provision or receipt of legally=protected health care activity that is lawful in the 103 commonwealth. 104 (c) Any false attestation submitted under this section shall be subject to a statutory 105 penalty of not more than $50,000 per violation. Submission of such attestation subjects the 106 attester to the jurisdiction of the courts of the commonwealth for any suit, penalty or damages 107 arising out of a false attestation under this section. 108 (d) The attorney general may bring a civil action for injunctive or other equitable relief to 109 compel any business entity that operates in the commonwealth and that provides electronic 110 communications services or remote computing services to residents of the commonwealth to 111 comply with this section. 112 SECTION 7. Section 21 of chapter 94C of the General Laws, as most recently amended 113 by section 6 of chapter 285 of the acts of 2024, is hereby further amended by striking the first 114 paragraph and inserting in place thereof the following:- 115 The pharmacist filling a written, electronic or oral prescription for a controlled substance 116 shall package the controlled substance in a container, affixing to the container a label showing 117 the date of filling, the pharmacy name and address, the filling pharmacist's initials, the serial 118 number of the prescription, the name of the patient, unless it is a veterinary prescription, the 119 name of the prescribing practitioner except as otherwise provided in this section, the name of the 120 controlled substance, directions for use and cautionary statements, if any, contained in such 7 of 21 121 prescription or required by law, and if the controlled substance is dispensed as tablets or capsules 122 the number of same in such container. 123 Except as required by federal law, the label for a controlled substance prescribed for 124 reproductive health care services or gender-affirming health care services, as defined in section 125 11I½ of chapter 12, shall, at the request of the provider, include the name of the prescribing 126 health care practice instead of the name of the prescribing practitioner; provided, however, that a 127 pharmacy benefit manager, as defined in section 1 of chapter 176Y, shall not recoup or recover 128 funds from a pharmacy due to the absence of such dispensing practitioner’s name under this 129 paragraph. The department may promulgate regulations to implement this paragraph. 130 SECTION 8. Section 22 of said chapter 94C, as appearing in the 2022 Official Edition, is 131 hereby amended by adding the following subsection:- 132 (d) Notwithstanding subsection (b) and to the extent allowable under federal law, the 133 label for a controlled substance prescribed for reproductive health care services or gender- 134 affirming health care services, as defined in section 11I½ of chapter 12, may include the name of 135 the dispensing health care practice instead of the name of the dispensing practitioner. 136 SECTION 9. Paragraph (1) of subsection (a) of section 24A of said chapter 94C, as so 137 appearing, is hereby amended by adding the following sentence:- 138 Notwithstanding any other provision of this section, medications that may be prescribed 139 for reproductive health care services and gender-affirming health care services, as defined in 140 section 11I1/2 of chapter 12, shall be excluded from the prescription monitoring program unless 141 reporting of such is determined by the department to be necessary to protect the public health. In 142 making a determination as to the scope of medications to be excluded from the prescription 8 of 21 143 monitoring program, the department shall consult with practitioners of reproductive health care 144 services and gender-affirming health care services. 145 SECTION 10. Said section 24A of said chapter 94C, as so appearing, is hereby further 146 amended by adding the following subsection:- 147 (n) Notwithstanding any general or special law to the contrary, except as required by 148 federal law, the department shall not provide disaggregated data or individually identifiable data, 149 from the prescription drug monitoring program to a federal law enforcement agency or other 150 agency or any other state or local law enforcement agency or other agency or any private citizen 151 or entity or quasi-law enforcement agent in relation to an investigation or inquiry into 152 reproductive health care services or gender-affirming health care services, as defined in section 153 11I½ of chapter 12, if such services would be lawful as provided had they occurred entirely in 154 the commonwealth. This section shall not be construed to apply to prescription drugs for usages, 155 including off-label usages, that are unrelated to reproductive health care services or gender- 156 affirming health care services. 157 SECTION 11. Chapter 111 of the General Laws is hereby amended by inserting after 158 section 51 the following section:- 159 Section 511/4. (a) For purposes of this section, the following terms shall have the 160 following meaning unless the context clearly requires otherwise: 161 “Emergency medical condition”, a medical condition manifesting itself by acute 162 symptoms of sufficient severity such that the absence of immediate medical attention could 163 reasonably be expected to result in: (i) placing the health of the patient in serious jeopardy; (ii) 164 serious impairment of bodily functions; or (iii) serious dysfunction of any bodily organ or part; 9 of 21 165 provided, however, that such conditions shall include, but shall not be limited to: ectopic 166 pregnancy, complications of pregnancy loss or abortion, active labor, risks to future fertility, 167 preterm premature rupture of membranes, placental abruption or bleeding from placenta previa 168 or emergent hypertensive disorders, such as preeclampsia and eclampsia and peripartum 169 cardiomyopathy, and any other condition a licensed health care provider, acting within their 170 lawful scope of practice, determines in the provider’s best medical judgment, to be an emergency 171 as defined in this paragraph. 172 “Patient”, any person who presents at the hospital or who is brought to a hospital by 173 ambulance or specialized emergency medical services vehicle as defined in section 1 of chapter 174 111C. 175 “Stabilizing treatment”, includes abortion when abortion is necessary to resolve the 176 patient’s injury or emergency medical condition. 177 (b) Acute-care hospitals licensed under section 51G, during all operating hours of an 178 emergency department or a satellite emergency facility as defined in section 511/2, shall provide 179 hospital emergency services to any patient who applies for the same in case of injury or an 180 emergency medical condition. Acute care hospitals shall furnish hospital emergency services, 181 including, but not limited to, medical screening by qualified medical personnel, to reach with 182 reasonable clinical confidence a determination of whether a patient has an emergency medical 183 condition and to provide necessary stabilizing treatment for patients with an emergency medical 184 condition. Acute care hospitals shall establish and maintain policies and procedures for the 185 provision of hospital emergency services, including for a patient’s refusal to consent, restricting 186 transfers until the patient is stabilized, appropriate transfers of patients, nondiscrimination in 10 of 21 187 providing services to patients, preventing delay in examination or treatment of patients and 188 whistleblower protections. 189 (c) The department may promulgate regulations to implement this section. 190 (d) The attorney general may bring a civil action for injunctive or other equitable relief to 191 enforce this section. In any action brought by the attorney general under this section, the court 192 may also award a civil penalty of not more than $10,000 for each violation. 193 SECTION 12. Said chapter 111 is hereby amended by inserting after section 70H the 194 following section:- 195 Section 70I. (a) For the purposes of this section, the following words shall have the 196 following meanings unless context clearly requires otherwise: 197 “Business”, (i) a business organized for the purpose of maintaining medical information 198 to make an individual’s medical information available to said individual or to a provider of 199 health care at the request of said individual or a provider of health care, for purposes of allowing 200 the individual or the provider to manage the individual’s medical information or for the diagnosis 201 and treatment of the individual; 202 (ii) a business that offers medical recordkeeping, electronic health records or electronic 203 medical record services, including, but not limited to, software or hardware, to consumers that 204 makes an individual’s medical information available to another person or a provider of health 205 care at the request of the individual or a provider of health care, for purposes of allowing the 206 other person or the provider to manage the individual’s medical information or for the diagnosis, 207 treatment or management of a medical condition of the individual; 11 of 21 208 (iii) any business that is licensed by the department of public health or the department of 209 mental health to provide medical, clinical, behavioral or health services; or 210 (iv) a business that offers a digital service to a consumer for the purpose of allowing such 211 consumer to manage the consumer’s reproductive or sexual health information or for the 212 diagnosis, treatment or management of a reproductive or sexual health medical condition of the 213 consumer. 214 “Gender affirming health care services”, as defined in section 11I1/2 of chapter 12. 215 “Reproductive health care services”, as defined in section 11I1/2 of chapter 12. 216 (b) A business that electronically stores or maintains medical information related to the 217 provision of reproductive health care services, in vitro fertilization and gender-affirming health 218 care services, including, but not limited to, on an electronic health record system or electronic 219 medical record system, on behalf of a provider of health care, health care insurance plan, 220 pharmaceutical company, pharmacy benefit manager, contractor or employer, shall develop 221 capabilities, policies and procedures to enable and shall enable features that: 222 (i) limit user access privileges to information systems that contain medical information 223 related to reproductive health care services, in vitro fertilization and gender-affirming health care 224 services only to those persons who are authorized in writing by the patient to access such 225 medical information; 226 (ii) prevent the disclosure, access, transfer, transmission or processing of medical 227 information related to reproductive health care services, in vitro fertilization or gender-affirming 228 health care services to persons and entities outside of the commonwealth, absent the express 12 of 21 229 written consent of the patient, independent of any other agreement, that specifically authorizes 230 the disclosure, access, transfer, transmission or processing of such medical information to the 231 named persons or entities outside of the commonwealth; and 232 (iii) automatically disable access by individuals and entities outside the commonwealth to 233 segregated medical information related to reproductive health care services, in vitro fertilization 234 or gender-affirming health care services, absent the express written consent of the patient that 235 specifically authorizes access by named persons or entities outside of this commonwealth to such 236 segregated medical information. 237 (c) The department may promulgate such regulations for licensed providers and entities 238 as may be necessary to implement this section. 239 (d) The department shall create a consent form that meets the requirements of this section 240 and shall require its use by all licensed health care providers in the commonwealth. 241 (e) The attorney general may bring a civil action for injunctive or other equitable relief to 242 enforce this section. In an action brought by the attorney general under this section, the court 243 may also award a civil penalty of not more than $5,000 per violation. 244 SECTION 13. Section 12Q of chapter 112 of the General Laws, as appearing in the 2022 245 Official Edition, is hereby amended by adding the following paragraph:- 246 The commissioner of public health shall not, pursuant to this section, collect, maintain, 247 use, disclose or disseminate disaggregated surveillance data or individually identifiable 248 surveillance data on abortions performed in the commonwealth. The name, home address, 249 personal email address and telephone number of individuals engaged in the provision, facilitation 13 of 21 250 or promotion of reproductive health care services, as defined in section 11I1/2 of chapter 12, 251 shall not be considered a public record under chapter 66. 252 SECTION 14. Said chapter 112 is hereby further amended by adding after section 12Q 253 the following section:- 254 Section 12Q1/2. The commissioner of public health shall not collect, maintain or use 255 individually identifiable data on gender-affirming health care services provided in the 256 commonwealth, as defined in section 11I1/2 of chapter 12, except as authorized by law, and shall 257 not disclose or disseminate disaggregated data or individually identifiable surveillance data on 258 gender-affirming health care services, as defined in said section 11I1/2 of said chapter 12, 259 provided in the commonwealth. The name, home address, personal email address, home 260 telephone number and mobile telephone number of individuals engaged in the provision, 261 facilitation or promotion of gender-affirming health care services, as defined in section 11I1/2 of 262 chapter 12, shall not be considered a public record under chapter 66. 263 SECTION 15. Section 61 of said chapter 112, as most recently amended by section 2 of 264 chapter 353 of the acts of 2024, is hereby further amended by adding the following 3 265 paragraphs:- 266 Notwithstanding any general or special law to the contrary, no person shall be subject to 267 discipline by a board of registration, including through the revocation, suspension or cancellation 268 of a certificate, registration or license, or a reprimand, censure or monetary fine, for providing or 269 assisting in the provision of reproductive health care services or gender-affirming health care 270 services, as those terms are defined in section 11I1/2 of chapter 12, or for any judgment, 271 discipline or other sanction arising from such health care services if the services as provided 14 of 21 272 would have been lawful and consistent with the standard of conduct for the designated profession 273 had they occurred entirely in the commonwealth. 274 No board of registration shall make available for public dissemination on an individual’s 275 profile the record of any criminal conviction or charge for a felony or serious misdemeanor, final 276 disciplinary action by a licensing board in another state or a malpractice court judgment, 277 arbitration award or settlement that resulted from providing or assisting in the provision of 278 reproductive health care services or gender-affirming health care services or for any judgment, 279 discipline or other sanction arising from such health care services if the services as provided 280 would have been lawful and consistent with the scope and standards of practice for the 281 designated profession had they occurred entirely in the commonwealth. 282 No board of registration shall take adverse action on an application for registration or 283 licensure based on a criminal or civil action or disciplinary action by a licensing board of another 284 state or a medical malpractice claim in another state that resulted from providing or assisting in 285 the provision of reproductive health care services or gender-affirming health care services that, 286 as provided, would have been lawful and consistent with the standard of conduct for the 287 designated profession had they occurred entirely in the commonwealth. 288 SECTION 16. Section 26 of chapter 119 of the General Laws, as appearing in the 2022 289 Official Edition, is hereby amended by adding the following subsection:- 290 (d) The removal of a child from the care or custody of a parent, custodian or guardian in 291 another jurisdiction based on the parent, custodian or guardian allowing their child to seek or 292 receive gender-affirming health care services, as defined in section 11I1/2 of chapter 12, shall 293 not provide a basis for adjudicating the child in need of care and protection under this section 15 of 21 294 unless the conduct of the parent, custodian or guardian would otherwise constitute abuse or 295 neglect under the law of the commonwealth. 296 SECTION 17. Section 63 of chapter 147 of the General Laws, as so appearing, is hereby 297 amended by striking out subsection (b) and inserting in place thereof the following 2 298 subsections:- 299 (b) Notwithstanding any general or special law to the contrary and except as required by 300 federal law, no state or local law enforcement agency or officer or employee or any other person 301 acting on behalf of a state or local law enforcement agency of the commonwealth, while acting 302 under color of law, shall provide information or assistance to a federal law enforcement agency 303 or any other state’s agency, including a law enforcement agency, or any private citizen or quasi- 304 law enforcement agent, or expend or use time, money, facilities, property, equipment, personnel 305 or other resources in relation to an investigation or inquiry into services constituting legally- 306 protected health care activity, as defined in section 11I1/2 of chapter 12, if such services would 307 be lawful as provided had they occurred entirely in the commonwealth. 308 (c) The attorney general may bring a civil action for injunctive or other equitable relief to 309 enforce this section. 310 SECTION 18. Chapter 175 of the General Laws is hereby amended by inserting after 311 section 193U the following section:- 312 Section 193V. No insurance company offering for sale any policy of insurance shall 313 discriminate against a nonprofit charitable organization, including those corporations qualified 314 under 26 USC section 501(c)(3), or adjust or otherwise calculate such nonprofit charitable 315 organization’s risk classification or premium charges in the provision of any form of liability 16 of 21 316 insurance covering negligence, wrongful acts, errors or omissions of the organization and its 317 respective members, directors and officers, solely on the basis that: (i) the organization offers 318 reproductive health care services or gender-affirming health care services, as those terms are 319 defined in section 11I1/2 of chapter 12; (ii) the organization engages in legally-protected health 320 care activity, as defined in said section 11I1/2 of said chapter 12; or (iii) the organization is or 321 has been the subject of abusive litigation, as defined in said section 11I1/2 of said chapter 12. 322 Nothing herein shall prohibit such insurers from establishing reasonable classifications of risks 323 and premium charges based upon the relative risk associated with practice in a particular 324 specialty. 325 SECTION 19. Chapter 176Q of the General Laws is hereby amended by adding the 326 following section:- 327 Section 19. (a) Except as required by federal law, the connector shall not provide access 328 to any data, including de-identified data or any other data that would allow the identification of a 329 patient, applicant or provider, in response to an out-of-state or federal inquiry or investigation 330 into services constituting legally-protected health care activity, as defined in section 11I1/2 of 331 chapter 12. 332 (b) The connector shall grant providers, provider organizations and public and private 333 health care payers access to identifiable health information of an individual solely for the 334 purposes of carrying out treatment, payment, health care operations or its functions as a health 335 insurance exchange. 17 of 21 336 (c) The connector shall not disclose, disseminate, transfer or otherwise allow access to 337 identifiable health information or other personally identifiable information of an individual for 338 any purpose not expressly authorized by this chapter. 339 (d) A recipient of de-identified or identifiable health information of an individual patient 340 or applicant shall not use such information to: (i) conduct a criminal, civil or administrative 341 investigation into any individual patient; or (ii) impose criminal, civil or administrative liability 342 on any individual patient. 343 SECTION 20. Chapter 208 of the General Laws is hereby amended by adding the 344 following section:- 345 Section 56. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 346 to be removed from the care or custody of a parent or guardian based on the parent or guardian 347 allowing their child to receive gender-affirming health care services, as defined in section 11I1/2 348 of chapter 12, or that bans the provision of gender-affirming health care services shall not 349 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 350 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 351 conduct of the parent or guardian under such law would constitute abuse, neglect or 352 maltreatment under the laws of the commonwealth. 353 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 354 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 355 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 356 parent or guardian is criminally, civilly or otherwise liable for violating another state’s law that 357 bans the provision of gender-affirming health care services as evidence in any proceeding with 18 of 21 358 respect to that parent or guardian and any of their children, unless the conduct of the parent or 359 guardian would constitute abuse, neglect or maltreatment under the laws of the commonwealth. 360 SECTION 21. Chapter 209A of the General Laws is hereby amended by adding the 361 following section:- 362 Section 12. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 363 to be removed from the care or custody of a parent or guardian based on the parent or guardian 364 allowing their child to receive gender-affirming health care services, as defined in section 11I1/2 365 of chapter 12, or that bans the provision of gender-affirming health care services shall not 366 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 367 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 368 conduct of the parent or guardian would constitute abuse, neglect or maltreatment under the laws 369 of the commonwealth. 370 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 371 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 372 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 373 parent or guardian is criminally, civilly or otherwise liable for violating another’s state’s law that 374 bans the provision of gender-affirming health care services as evidence in any proceeding in 375 which such parent or guardian and any of such parent’s or guardian’s children are parties, unless 376 the conduct of the parent or guardian would constitute abuse, neglect or maltreatment under the 377 laws of the commonwealth. 378 SECTION 22. Chapter 209B of the General Laws is hereby amended by adding the 379 following section:- 19 of 21 380 Section 15. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 381 to be removed from the care or custody of a parent or guardian based on the parent or guardian 382 allowing their child to receive gender-affirming care health care services, as defined in section 383 11I1/2 of chapter 12, or that bans the provision of gender-affirming health care services shall not 384 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 385 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 386 conduct of the parent or guardian would constitute abuse, neglect or maltreatment under the laws 387 of the commonwealth. 388 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 389 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 390 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 391 parent or guardian is criminally, civilly or otherwise liable for violating another’s state’s law that 392 bans the provision of gender-affirming health care services as evidence in any proceeding with 393 respect to that parent or guardian and any of their children, unless the conduct of the parent or 394 guardian would constitute abuse, neglect or maltreatment under the laws of the commonwealth. 395 SECTION 23. Chapter 209C of the General Laws is hereby amended by adding the 396 following section:- 397 Section 25. (a) A law of a jurisdiction outside the commonwealth that authorizes a child 398 to be removed from the care or custody of a parent or guardian based on the parent or guardian 399 allowing their child to receive gender-affirming health care services, as defined in section 11I1/2 400 of chapter 12, or that bans the provision of gender-affirming health care services shall not 401 provide a basis to alter custody, parenting time or visitation or be used to make a finding of 20 of 21 402 abuse, neglect or maltreatment in a case pending in a court in the commonwealth, unless the 403 conduct of the parent or guardian would constitute abuse, neglect or maltreatment under the laws 404 of the commonwealth. 405 (b) No court in the commonwealth shall admit or consider a finding of abuse, neglect or 406 maltreatment based on a parent or guardian allowing their child to receive or seek gender- 407 affirming health care services, as defined in section 11I1/2 of chapter 12, or a finding that a 408 parent or guardian is criminally, civilly or otherwise liable for violating another state’s law that 409 bans the provision of gender-affirming health care services as evidence in any proceeding in 410 which such parent or guardian and any of such parent’s or guardian’s children are parties, unless 411 the conduct of such parent or guardian would constitute abuse, neglect or maltreatment under the 412 laws of the commonwealth. 413 SECTION 24. Chapter 221 of the General Laws is hereby amended by inserting after 414 section 40 the following section:- 415 Section 40A. Notwithstanding any general or special law or rule or regulation to the 416 contrary, no attorney licensed in the commonwealth may be removed or otherwise subject to 417 discipline, including through the revocation, suspension or cancellation of the attorney’s license 418 or reprimand, censure or monetary fine, for advising or representing a client or prospective client 419 on or in a matter related to the provision of reproductive health care services or gender-affirming 420 health care services, as those terms are defined in section 11I1/2 of chapter 12, if the sole basis 421 for such removal or discipline is that: (i) the client offered, provided or received reproductive 422 health care services or gender-affirming health care services that are unlawful in another state; 423 (ii) another state’s laws creates actual or potential liability for the reproductive health care 21 of 21 424 services or gender-affirming health care services offered, provided or received by the client; or 425 (iii) the attorney is subject to actual or potential liability, or removal or discipline, in another 426 jurisdiction based on the reproductive health care services or gender-affirming health care 427 services offered, provided or received by the client; provided, however, that the attorney’s 428 conduct shall otherwise comply with the laws of the commonwealth and meet the standards set 429 forth in the rules of professional conduct promulgated by the supreme judicial court. 430 SECTION 25. Section 7 shall take effect January 1, 2026. 431 SECTION 26. Subsection (b) of section 70I of chapter 111 of the General Laws shall take 432 effect not later than July 1, 2026.