The bill amends the General Laws to include a new section that defines the role of community health workers and the scope of their services, such as health promotion, education, system navigation, care planning, and follow-up care recommendations. It requires that, starting January 1, 2025, all individual or group health insurance contracts and policies in the state must cover services provided by community health workers, as long as these services are within the worker's professional competence and are reimbursed when provided by other healthcare providers. The bill prohibits insurers from requiring supervision or referral by another healthcare provider for reimbursement of community health worker services, unless the same is required for other providers, and it prevents payment for duplicate services. It also mandates that insurers report utilization and cost information related to these services by July 1, 2026, and annually thereafter, while exempting certain types of insurance from these requirements.

The bill's provisions ensure that community health worker services are recognized and covered by health insurance plans, reflecting their importance in managing chronic health conditions and addressing barriers to health needs. It establishes that these services must be covered when they align with the community health worker's certified competencies and are consistent with reimbursement principles for other healthcare providers. The bill also aims to prevent unnecessary administrative barriers to reimbursement and duplication of services, while requiring insurers to provide data on the utilization and costs of community health worker services to the health insurance commissioner. The act will take effect upon passage, with specific reporting requirements beginning in 2026.