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Postponement in the Massachusetts Patients First Act Penalties

On July 5, 2022, the Commonwealth of Massachusetts re-extended the implementation and enforcement date for the “Patients First Act”, sometimes referred to as the Massachusetts No Surprises Act, to January 1, 2025. As discussed in our prior blog, this law requires Massachusetts health care providers to disclose additional information to their patients about the cost of scheduled hospital stays, medical procedures, health care services, or referrals, based on the patient’s specific health insurance.

The penalties in Massachusetts were originally set to start on January 1, 2022. The Massachusetts Department of Public Health first delayed these penalties until July 31, 2022, and recently re-extended the enforcement date to January 1, 2025. Many in the industry struggled with how to operationalize the new Massachusetts law while simultaneously addressing the Federal No Surprises Act and regulations that have overlapping obligations. This new delay in implementation reflects the Commonwealth’s appreciation of those challenges. We should also note that our reading of the statute is that not only are the penalties delayed, but the statute is not self-implementing and implementation is delayed as well, meaning that the requirements under this law are not effective until January 1, 2025.

Delayed implementation and enforcement for non-compliance with the Patients First Act and the Federal No Surprises Act illustrates the complexities in solving the industry-wide problem of out-of-network billing.

It’s important to note that this new section of the law, now not effective until January 1, 2025, replaced any prior statutory language in MGL 111 sec. 228 requiring providers to give patients or prospective patients allowed amounts upon request.

Thank you to co-author Ilana Meyer, a summer associate in Foley's Boston office, for her contributions to this post.

© 2022 Foley & Lardner LLPNational Law Review, Volume XII, Number 216
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About this Author

Lawrence W. Vernaglia, Health Care Attorney, Foley Lardner Law Firm
Partner

Lawrence Vernaglia is a partner and health care lawyer with Foley & Lardner LLP and serves as chair of the firm’s Health Care Industry Team – named “Health Law Firm of the Year” for three of the past four years on the U.S. News - Best Lawyers® "Best Law Firms" list. Mr. Vernaglia represents hospitals, health systems and academic medical centers and a variety of other health care providers. Mr. Vernaglia's practice involves regulatory and transactional matters, including Medicare/Medicaid reimbursement compliance advice and appeals; mergers, acquisitions and...

617-342-4079
Alexandra Shalom Health Care Lawyer Foley Lardner
Associate

Alexandra (Allie) Shalom is an associate and health care business lawyer with Foley & Lardner LLP, and a member of the firm’s Health Care Practice Group.

Allie's practice focuses on counseling clients in the health care, pharmacy, and medical device industries with respect to a wide range of regulatory and compliance matters. Her experience includes advising clients on Medicare and Medicaid reimbursement; internal investigations; managed care and value based payment arrangements; self-disclosures; federal and state fraud and abuse compliance; and state licensure issues. She also...

617-502-3272
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