Advancing Primary Prevention in the Opioid Epidemic – Chapter 285 Implementation

Subject: Meeting Purpose and Agenda – Supporting Chapter 285 Implementation

The purpose of this meeting is to discuss how the Massachusetts Chiropractic Society (MCS) can support the statewide implementation of Chapter 285 of the Acts of 2024, which addresses pain management reform, opioid reduction strategies, and expanded access to non-pharmacologic care.

We look forward to a productive discussion focused on collaboration, policy alignment, and ensuring that chiropractic care is recognized and integrated as part of the state’s comprehensive pain management approach.

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Meeting Agenda
Topic: Implementation of Chapter 285 – Broad Spectrum of Pain Management

1. Welcome & Introductions

   • Meeting objectives

   • Brief overview of MCS engagement on Chapter 285

2. The Importance of Primary Prevention

   • The role of chiropractic care in reducing opioid initiation

   • Positioning non-opioid options as first-line care

3. Addressing Insurance System Barriers

   • Current patient challenges accessing chiropractic care

   • Insurance design structures that may inadvertently favor opioid prescriptions

4. Review of DOI Filing Guidance 2025-F

   • Request for clarification and input on:
     a. Definition of “Adequate” coverage
     b. “Preferential” vs. “Unduly Preferential” coverage
     c. The “List” of alternative treatments – concern over surface-level compliance
     d. Review of “Material Change” documentation (Evidence of Coverage)

5. Stakeholder Inclusion & Representation

   • Section 3 of Chapter 285: Request for MCS participation in prescriber training development

   • Call for ongoing inclusion of chiropractic and other non-pharmacologic stakeholders

6. Action Items & Next Steps

   • Timeline and opportunities for MCS to review DOI guidance

   • Planning for coordination ahead of the July 1, 2025 implementation deadline

   • Establishing continued engagement and feedback mechanisms

Key Question for Discussion:
Can the Division of Insurance clarify its response process when a carrier’s plan appears to favor or incentivize opioid prescribing over non-opioid alternatives? Additionally, what safeguards will be in place to ensure ongoing compliance and accountability in these cases?

We appreciate your collaboration and look forward to working together toward effective, equitable implementation of Chapter 285.