Massachusetts delays patient cost disclosure rules again
State lawmakers pushed the start date for the Patients First Act from 2027 to 2029, citing conflicts with federal standards and administrative burdens.
By Riya Zhao ·
Massachusetts patients will wait another two years to receive specific cost disclosures before non-emergency medical procedures. State lawmakers embedded a provision in the recent supplemental budget that moves the effective date of the Patients First Act from January 1, 2027, to 2029. The measure is part of a spending package currently facing a vote in the Senate Ways and Means Committee.
The state legislature tucked this delay into a $2.35 billion supplemental budget passed last month. The primary justification offered by committee members is the need to avoid conflicting with federal regulations. A spokesperson for the Senate Ways and Means Committee stated that additional time is necessary to understand the implementation of the federal No Surprises Act. The committee aims to prevent unnecessary administrative complexity for providers.
The federal No Surprises Act took effect in January 2022. It protects patients from unexpected out-of-network bills at in-network facilities. It also established an independent dispute resolution process between insurers and providers. However, that framework has faced litigation. House Ways and Means officials described the state delay as necessary to avoid clashing with federal standards that have not yet been fully issued.
Governor Maura Healey did not include this specific delay in her initial proposal for the fiscal 2026 budget. Her administration previously pushed back the implementation date from 2025 to 2027 via a supplemental budget in December 2024. A spokesperson for the governor did not clarify whether she supports the new two-year extension or believes the law remains necessary as her term ends.
The Massachusetts Association of Health Plans opposes the latest postponement. CEO Lora Pellegrini argued that provider transparency requirements are essential for patients to make informed decisions about care costs. She stated that repeatedly delaying enforcement undermines statutory tools designed to help patients understand financial implications. Pellegrini noted that meaningful transparency depends on accountability.
The Massachusetts Dental Society also requested a delay. President Steven Spitz wrote to the governor in September asking for a push to January 1, 2028. Spitz said dental practices lack clarity on how to comply with regulations, such as providing financial information about other providers during referrals. He noted that the administration has not answered specific questions about compliance.
The Massachusetts Medical Society supports a separate bill to align state rules with federal standards. The society argues that current state and federal laws take different approaches and contain different timeframes. This makes compliance virtually impossible for physicians and health systems. The society warned that having two different and sometimes conflicting disclosure requirements would be confusing and detrimental to patients.
The state Department of Public Health has the authority to fine providers up to $2,500 for non-compliance with transparency requirements. The department did not request the latest proposed delay, according to a Senate official. The Patients First Act requires providers to disclose whether they are covered under a patient’s health insurance plan when scheduling hospital stays and procedures.
