The bill amends Chapter 40-8.9 of the General Laws regarding "Medical Assistance Long-Term Care Service and Finance Reform" by introducing a new section on Medicaid bed hold requirements for assisted living services. It specifies that a licensed assisted living community is not required to hold a residential unit for a Medicaid-eligible resident who is temporarily absent due to hospitalization or admission to a skilled nursing facility for a period exceeding ten (10) days, unless a Medicaid bed hold payment is provided. For any required bed hold period beyond ten (10) days, the executive office of health and human services shall provide a Medicaid bed hold payment to the assisted living community at a rate not less than fifty percent (50%) of the resident's assessed Medicaid assisted living reimbursement rate. Furthermore, no assisted living community shall be required to maintain an unpaid bed hold for a Medicaid resident for a period exceeding forty-five (45) days in total, regardless of anticipated return status. The bill allows assisted living communities to voluntarily hold a unit for a longer period or enter into private payment arrangements with the resident or the resident's representative. The provisions of this section apply only where the assisted living community has received written notice that the resident is reasonably expected to return to the assisted living setting. Additionally, the executive office of health and human services is required to amend its regulations governing assisted living services to conform with this section and to submit any necessary Medicaid state plan amendments or waivers required for implementation. The act will take effect upon passage and will apply to Medicaid-assisted living residents who are absent on or after July 1, 2026.