The bill amends the General Laws to recognize community health workers as professionals who provide essential services to individuals with chronic health conditions or those facing barriers to health. It defines the scope of services that community health workers can provide, which includes health promotion, education, system navigation, and care planning. Starting January 1, 2025, health insurance contracts and policies in the state must cover the services of community health workers, with the coverage subject to the insurer's reimbursement, credentialing, and contracting principles. The bill prohibits insurers from requiring supervision or referral by another healthcare provider for reimbursement of community health worker services unless such requirements are imposed on other healthcare providers. It also prevents payment for duplicate services by a community health worker and another provider and mandates reporting of utilization and cost information related to these services by July 1, 2026, and annually thereafter.

The bill specifies that the new coverage requirements do not apply to various types of limited benefit policies, such as those for hospital confinement indemnity, disability income, accident only, long-term care, and specified disease indemnity. It ensures that community health worker services are integrated into the healthcare system and reimbursed without unnecessary restrictions. The act will take effect upon passage, signaling a significant change in the way community health worker services are recognized and covered by health insurance in the state.