S 2938

SENATE . . . . . . . . . . . . . . No. 2938
  The Commonwealth of Massachusetts
  _______________
  In the One Hundred and Ninety-Fourth General Court
  (2025-2026)
  _______________
  SENATE, February 9, 2026.
  The committee on Health Care Financing to whom was referred the Senate Bill to
promote increased access to patient care through equitable reimbursement (Senate, No. 783), -
reports, recommending that the same ought to pass with an amendment substituting a new draft
with the same title (Senate, No. 2938).
  For the committee,
  Cindy F. Friedman
  FILED ON: 1/27/2026
 SENATE . . . . . . . . . . . . . . No. 2938
  The Commonwealth of Massachusetts
  _______________
  In the One Hundred and Ninety-Fourth General Court
  (2025-2026)
  _______________
     An Act to promote increased access to patient care through equitable reimbursement.
  Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
     of the same, as follows:
1SECTION 1. Chapter 32A of the General Laws is hereby amended by adding the
2 following section:—
3Section 35. (a) (1) Coverage offered by the commission to an active or retired employee
4 of the commonwealth insured under the commission shall not make a distinction, for the
5 purposes of participation, coverage, and payment, between physicians licensed pursuant to
6 chapter 112 and certified registered nurse anesthetists authorized to practice in an advanced
7 practice nursing role pursuant to section 80B of chapter 112, if the physician or certified
8 registered nurse anesthetist is acting within the scope of their practice pursuant to their licensure
9 and certification. Nothing in this subsection shall prevent the commission from establishing
10 varying reimbursement rates based on quality or performance measures if such measures are the
11 same for physicians licensed pursuant to chapter 112 and certified registered nurse anesthetists
12 authorized to practice in advanced practice nursing roles pursuant to said section 80B.
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13(b) A claim submitted for payment must identify the National Provider Identifier of the
14 physician or certified registered nurse anesthetist who provided the service.
15(c) (1) The commission shall reimburse a contracted certified registered nurse anesthetist
16 who is authorized to practice in an advanced practice nursing role pursuant to said section 80B in
17 an amount not less than the allowed amount that the commissioner of insurance would reimburse
18 for the same service if provided by a contracted provider who is a physician licensed pursuant to
19 chapter 112.
20(2) The commission may not reduce the reimbursement amount paid to physicians
21 licensed under chapter 112 to comply with this subsection.
22SECTION 2. Section 6 of chapter 118E of the General Laws, as appearing in the 2024
23 Official Edition, is hereby amended by inserting after the words “board-certified physicians”, in
24 lines 6 and 7, the following words:—
25, certified registered nurse anesthetists
26SECTION 3. Said chapter 118E of the General Laws is hereby further amended by
27 adding the following section:—
28Section 87. (a) (1) The division and its contracted health insurers, health plans, health
29 maintenance organizations, behavioral health management firms and third-party administrators
30 under contract to a Medicaid-managed care organization, accountable care organization, or
31 primary care clinician plan shall not make a distinction, for the purposes of participation,
32 coverage, and payment, between physicians licensed pursuant to chapter 112 and certified
33 registered nurse anesthetists authorized to practice in an advanced practice nursing role pursuant
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34 to section 80B of chapter 112, if the physician or certified registered nurse anesthetist is acting
35 within the scope of their practice pursuant to their licensure and certification. Nothing in this
36 subsection shall prevent the division from establishing varying reimbursement rates based on
37 quality or performance measures if such measures are the same for physicians licensed pursuant
38 to chapter 112 and certified registered nurse anesthetists authorized to practice in advanced
39 practice nursing roles pursuant to said section 80B.
40(b) A claim submitted for payment must identify the National Provider Identifier of the
41 physician or certified registered nurse anesthetist who provided the service.
42(c) The division and its contracted entities shall: (i) reimburse a contracted certified
43 registered nurse anesthetist who is authorized to practice in an advanced practice nursing role
44 pursuant to said section 80B in an amount not less than the allowed amount that it would
45 reimburse for the same service if provided by a contracted provider who is a physician licensed
46 pursuant to chapter 112; and (ii) not reduce the reimbursement amount paid to physicians
47 licensed under chapter 112 to comply with this subsection.
48SECTION 4. Chapter 175 of the General Laws, as appearing in the 2024 Official Edition,
49 is hereby amended by inserting after section 108N the following section:—
50Section 108O. (a) (1) An individual policy of accident and sickness insurance issued
51 under section 108 that provides hospital expense and surgical expense insurance and any group
52 blanket or general policy of accident and sickness insurance issued under section 110 that
53 provides hospital expense and surgical expense insurance that is issued or renewed within or
54 without the commonwealth shall not make a distinction, for the purposes of participation,
55 coverage, and payment, between physicians licensed pursuant to chapter 112 and certified
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56 registered nurse anesthetists authorized to practice in an advanced practice nursing role pursuant
57 to section 80B of chapter 112, if the physician or certified registered nurse anesthetist is acting
58 within the scope of their practice pursuant to their licensure and certification. Nothing in this
59 subsection shall prevent the commissioner from establishing varying reimbursement rates based
60 on quality or performance measures as long as such measures are the same for physicians
61 licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized to practice
62 in an advanced practice nursing role pursuant to said section 80B.
63(b) A claim submitted for payment must identify the National Provider Identifier of the
64 physician or certified registered nurse anesthetist who provided the service.
65(c) An individual policy of accident and sickness insurance issued under section 108 that
66 provides hospital expense and surgical expense insurance and any group blanket or general
67 policy of accident and sickness insurance issued under section 110 that provides hospital expense
68 and surgical expense insurance that is issued or renewed within or without the commonwealth
69 shall: (i) reimburse a contracted certified registered nurse anesthetist who is authorized to
70 practice in an advanced practice nursing role pursuant to said section 80B in an amount not less
71 than the allowed amount that it would reimburse for the same service if provided by a contracted
72 provider who is a physician licensed pursuant to chapter 112; and (ii) not reduce the
73 reimbursement amount paid to physicians licensed under chapter 112 to comply with this
74 section.
75SECTION 5. Chapter 176A of the General Laws is hereby amended by adding the
76 following section:—
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77Section 39. Any contract between a subscriber and a corporation under an individual or
78 group hospital service plan delivered, issued or renewed within the commonwealth shall not
79 make a distinction, for the purposes of participation, coverage, and payment, between physicians
80 licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized to practice
81 in an advanced practice nursing role pursuant to section 80B of chapter 112, if the physician or
82 certified registered nurse anesthetist is acting within the scope of their practice pursuant to their
83 licensure and certification. Nothing in this subsection shall prevent the commissioner of
84 insurance from establishing varying reimbursement rates based on quality or performance
85 measures if such measures are the same for physicians licensed pursuant to chapter 112 and
86 certified registered nurse anesthetists authorized to practice in an advanced practice nursing role
87 pursuant to said section 80B.
88(b) A claim submitted for payment must identify the National Provider Identifier of the
89 physician or certified registered nurse anesthetist who provided the service.
90(c) Any contract between a subscriber and a corporation under an individual or group
91 hospital service plan delivered, issued or renewed within the commonwealth shall: (i) reimburse
92 a contracted certified registered nurse anesthetist who is authorized to practice in an advanced
93 practice nursing role pursuant to said section 80B in an amount not less than the allowed amount
94 that it would reimburse for the same service if provided by a contracted provider who is a
95 physician licensed pursuant to chapter 112; and (ii) not reduce the reimbursement amount paid to
96 physicians licensed under chapter 112 to comply with this section.
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97SECTION 6. Section 1 of chapter 176B of the General Laws, as appearing in the 2024
98 Official Edition, is hereby amended by inserting after the definition of “'Certified nurse
99 midwife'', the following definition:—
100“Certified registered nurse anesthetist”, a registered nurse who is authorized to practice in
101 an advanced practice nursing role as a certified registered nurse anesthetist pursuant to section
102 80B of chapter 112.
103SECTION 7. Said section 1 of said chapter 176B, as so appearing, is hereby further
104 amended by inserting after the word “physicians” in the definition of “Medical service”, in line
105 13, the following words:—
106or certified registered nurse anesthetists
107SECTION 8. Said section 1 of said chapter 176B, as so appearing, is hereby further
108 amended by inserting, after the definition of “Nonprofit medical service plan”, the following
109 definition:—
110“Participating certified registered nurse anesthetist”, a certified registered nurse
111 anesthetist who is authorized to practice in an advanced practice nursing role pursuant to section
112 80B of chapter 112, and who agrees in writing with a medical service corporation to perform
113 medical services for subscribers and covered dependents and to abide by the by-laws, rules and
114 regulations of such corporation.
115SECTION 9. Said chapter 176B, as so appearing, is hereby further amended in section 4T
116 by striking out, wherever they appear, the words “certified registered nurse anesthetist or”.
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117SECTION 10. Said chapter 176B of the General Laws is hereby further amended by
118 adding the following section:—
119Section 26. A contract between a subscriber and a medical service corporation shall not
120 make a distinction, for the purposes of participation, coverage, and payment, between physicians
121 licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized to practice
122 in an advanced practice nursing role pursuant to section 80B of chapter 112, if the physician or
123 certified registered nurse anesthetist is acting within the scope of their practice pursuant to their
124 licensure and certification. Nothing in this subsection shall prevent the commissioner from
125 establishing varying reimbursement rates based on quality or performance measures if such
126 measures are the same for physicians licensed pursuant to chapter 112 and certified registered
127 nurse anesthetists authorized to practice in an advanced practice nursing role pursuant to said
128 section 80B.
129(b) A claim submitted for payment must identify the National Provider Identifier of the
130 physician or certified registered nurse anesthetist who provided the service.
131(c) A contract between a subscriber and a medical service corporation shall: (i) reimburse
132 a contracted certified registered nurse anesthetist who is authorized to practice in an advanced
133 practice nursing role pursuant to said section 80B in an amount not less than the allowed amount
134 that it would reimburse for the same service if provided by a contracted provider who is a
135 physician licensed pursuant to chapter 112; and (ii) not reduce the reimbursement amount paid to
136 physicians licensed under chapter 112 to comply with this section.
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137SECTION 11. Section 1 of chapter 176G of the General Laws, as appearing in the 2024
138 Official Edition, is hereby amended by inserting, after the definition of “Carriers”, the following
139 definition:—
140“Certified registered nurse anesthetist”, A certified registered nurse anesthetist who is
141 authorized to practice in an advanced practice nursing role pursuant to section 80B of chapter
142 112.
143SECTION 12. Said section 1 of said chapter 176G, as so appearing, is hereby further
144 amended by inserting after the word “physician” in the definition of “Health services”, in line 82,
145 the following:—
146or certified registered nurse anesthetist
147SECTION 13. Said chapter 176G of the General Laws is hereby amended by adding the
148 following sections:-
149Section 34. A contract between a member and a health maintenance organization shall
150 not make a distinction, for the purposes of participation, coverage, and payment, between
151 physicians licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized
152 to practice in an advanced practice nursing role pursuant to section 80B of chapter 112, if the
153 physician or certified registered nurse anesthetist is acting within the scope of their practice
154 pursuant to their licensure and certification. Nothing in this subsection shall prevent the
155 commissioner from establishing varying reimbursement rates based on quality or performance
156 measures as long as such measures are the same for physicians licensed pursuant to chapter 112
157 and certified registered nurse anesthetists authorized to practice in an advanced practice nursing
158 role pursuant to said section 80B
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159(b) A claim submitted for payment must identify the National Provider Identifier of the
160 physician or certified registered nurse anesthetist who provided the service.
161(c) A contract between a member and a health maintenance organization shall: (i)
162 reimburse a contracted certified registered nurse anesthetist who is authorized to practice in an
163 advanced practice nursing role pursuant to said section 80B in an amount not less than the
164 allowed amount that it would reimburse for the same service if provided by a contracted provider
165 who is a physician licensed pursuant to chapter 112; and (ii) not reduce the reimbursement
166 amount paid to physicians licensed under chapter 112 to comply with this section.
167Section 35. When a law or rule requires authorization or involvement of a physician as a
168 condition of reimbursement or coverage of anesthesia services, that requirement may be fulfilled
169 by a certified registered nurse anesthetist practicing in an advanced practice role under section
170 80B of chapter 112.
171SECTION 14. Chapter 176I of the General Laws is hereby amended by adding the
172 following section:-
173Section 14. A preferred provider contract between a covered person and an organization
174 shall not make a distinction, for the purposes of participation, coverage, and payment, between
175 physicians licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized
176 to practice in an advanced practice nursing role pursuant to section 80B of said chapter 112, if
177 the physician or advanced practice registered nurse is acting within the scope of their practice
178 pursuant to their licensure and certification. Nothing in this subsection shall prevent the
179 commissioner from establishing varying reimbursement rates based on quality or performance
180 measures as long as such measures are the same for physicians licensed pursuant to chapter 112
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181 and certified registered nurse anesthetists practicing authorized to practice in an advanced
182 practice nursing role pursuant to section 80B of said chapter 112.
183(b) A claim submitted for payment must identify the National Provider Identifier of the
184 physician or advanced practice registered nurse who provided the service.
185(c) A preferred provider arrangement between a covered person and an organization
186 shall: (i) reimburse a preferred provider certified registered nurse anesthetist who is authorized to
187 practice in an advanced practice nursing role pursuant to section 80B of chapter 112 in an
188 amount not less than the allowed amount that it would reimburse for the same service if provided
189 by a preferred provider who is a physician licensed pursuant to said chapter 112; and (ii) not
190 reduce the reimbursement amount paid to physicians licensed under chapter 112 to comply with
191 this section.
192SECTION 15. The commissioner of insurance shall promulgate rules and
193 regulations for the implementation and enforcement of the provisions of this act.
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