WHAT THIS BILL REGULATES · 4 REQUIREMENT TYPES
How Is This Bill Enforced
Verbatim statutory text on the left; plain-language analysis and a per-section checklist on the right. Numbered markers cross-link to the matching checklist row.
(a) As used in this section, unless the context otherwise requires: "Administrative supportAdministrative support"Administrative support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve communication. "Administrative support" includes, but is not limited to, the following: (1) managing appointment scheduling and reminders; (2) processing billing and insurance claims; and (3) drafting general communications related to therapy logistics that do not include therapeutic advice.G.L. c. 112, § 298(a)" means tasks performed to assist a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) in the delivery of therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a) that do not involve communication. "Administrative supportAdministrative support"Administrative support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve communication. "Administrative support" includes, but is not limited to, the following: (1) managing appointment scheduling and reminders; (2) processing billing and insurance claims; and (3) drafting general communications related to therapy logistics that do not include therapeutic advice.G.L. c. 112, § 298(a)" includes, but is not limited to, the following: (1) managing appointment scheduling and reminders; (2) processing billing and insurance claims; and (3) drafting general communications related to therapy logistics that do not include therapeutic advice. "Artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a)" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments. "ConsentConsent"Consent" means a clear, explicit affirmative act by an individual that: (i) unambiguously communicates the individual's express, freely given, informed, voluntary, specific, and unambiguous written agreement, including a written agreement provided by electronic means, and (ii) is revocable by the individual. "Consent" does not include an agreement that is obtained by the following: (1) the acceptance of a general or broad terms of use agreement or a similar document that contains description of artificial intelligence along with other unrelated information; (2) an individual hovering over, muting, pausing, or closing a given piece of digital content; or (3) an agreement obtained through the use of deceptive actions.G.L. c. 112, § 298(a)" means a clear, explicit affirmative act by an individual that: (i) unambiguously communicates the individual's express, freely given, informed, voluntary, specific, and unambiguous written agreement, including a written agreement provided by electronic means, and (ii) is revocable by the individual. "ConsentConsent"Consent" means a clear, explicit affirmative act by an individual that: (i) unambiguously communicates the individual's express, freely given, informed, voluntary, specific, and unambiguous written agreement, including a written agreement provided by electronic means, and (ii) is revocable by the individual. "Consent" does not include an agreement that is obtained by the following: (1) the acceptance of a general or broad terms of use agreement or a similar document that contains description of artificial intelligence along with other unrelated information; (2) an individual hovering over, muting, pausing, or closing a given piece of digital content; or (3) an agreement obtained through the use of deceptive actions.G.L. c. 112, § 298(a)" does not include an agreement that is obtained by the following: (1) the acceptance of a general or broad terms of use agreement or a similar document that contains description of artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) along with other unrelated information; (2) an individual hovering over, muting, pausing, or closing a given piece of digital content; or (3) an agreement obtained through the use of deceptive actions. "DivisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a)" means the Division of Occupational Licensure. "Licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a)" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a), including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a); (8) a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a), except for a physician. "Peer supportPeer support"Peer support" means services provided by individuals with lived experience of mental health conditions or recovery from substance use that are intended to offer encouragement, understanding, and guidance without clinical intervention.G.L. c. 112, § 298(a)" means services provided by individuals with lived experience of mental health conditions or recovery from substance use that are intended to offer encouragement, understanding, and guidance without clinical intervention. "Religious counselingReligious counseling"Religious counseling" means counseling provided by clergy members, pastoral counselors, or other religious leaders acting within the scope of their religious duties if the services are explicitly faith-based and are not represented as clinical mental health services or therapy or psychotherapy services.G.L. c. 112, § 298(a)" means counseling provided by clergy members, pastoral counselors, or other religious leaders acting within the scope of their religious duties if the services are explicitly faith-based and are not represented as clinical mental health services or therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a). "Supplementary supportSupplementary support"Supplementary support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve therapeutic communication and that are not administrative support. "Supplementary support" includes, but is not limited to, the following: (1) preparing and maintaining client records, including therapy notes; (2) analyzing anonymized data to track client progress or identify trends, subject to review by a licensed professional; and (3) identifying and organizing external resources or referrals for client use.G.L. c. 112, § 298(a)" means tasks performed to assist a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) in the delivery of therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a) that do not involve therapeutic communicationTherapeutic communication"Therapeutic communication" means any verbal, non-verbal, or written interaction conducted in a clinical or professional setting that is intended to diagnose, treat, or address an individual's mental, emotional, or behavioral health concerns. "Therapeutic communication" includes, but is not limited to: (1) direct interactions with clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences; (2) providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes; (3) offering emotional support, reassurance, or empathy in response to psychological or emotional distress; (4) collaborating with clients to develop or modify therapeutic goals or treatment plans; and (5) offering behavioral feedback intended to promote psychological growth or address mental health conditions.G.L. c. 112, § 298(a) and that are not administrative supportAdministrative support"Administrative support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve communication. "Administrative support" includes, but is not limited to, the following: (1) managing appointment scheduling and reminders; (2) processing billing and insurance claims; and (3) drafting general communications related to therapy logistics that do not include therapeutic advice.G.L. c. 112, § 298(a). "Supplementary supportSupplementary support"Supplementary support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve therapeutic communication and that are not administrative support. "Supplementary support" includes, but is not limited to, the following: (1) preparing and maintaining client records, including therapy notes; (2) analyzing anonymized data to track client progress or identify trends, subject to review by a licensed professional; and (3) identifying and organizing external resources or referrals for client use.G.L. c. 112, § 298(a)" includes, but is not limited to, the following: (1) preparing and maintaining client records, including therapy notes; (2) analyzing anonymized data to track client progress or identify trends, subject to review by a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a); and (3) identifying and organizing external resources or referrals for client use. "Therapeutic communicationTherapeutic communication"Therapeutic communication" means any verbal, non-verbal, or written interaction conducted in a clinical or professional setting that is intended to diagnose, treat, or address an individual's mental, emotional, or behavioral health concerns. "Therapeutic communication" includes, but is not limited to: (1) direct interactions with clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences; (2) providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes; (3) offering emotional support, reassurance, or empathy in response to psychological or emotional distress; (4) collaborating with clients to develop or modify therapeutic goals or treatment plans; and (5) offering behavioral feedback intended to promote psychological growth or address mental health conditions.G.L. c. 112, § 298(a)" means any verbal, non-verbal, or written interaction conducted in a clinical or professional setting that is intended to diagnose, treat, or address an individual's mental, emotional, or behavioral health concerns. "Therapeutic communicationTherapeutic communication"Therapeutic communication" means any verbal, non-verbal, or written interaction conducted in a clinical or professional setting that is intended to diagnose, treat, or address an individual's mental, emotional, or behavioral health concerns. "Therapeutic communication" includes, but is not limited to: (1) direct interactions with clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences; (2) providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes; (3) offering emotional support, reassurance, or empathy in response to psychological or emotional distress; (4) collaborating with clients to develop or modify therapeutic goals or treatment plans; and (5) offering behavioral feedback intended to promote psychological growth or address mental health conditions.G.L. c. 112, § 298(a)" includes, but is not limited to: (1) direct interactions with clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences; (2) providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes; (3) offering emotional support, reassurance, or empathy in response to psychological or emotional distress; (4) collaborating with clients to develop or modify therapeutic goals or treatment plans; and (5) offering behavioral feedback intended to promote psychological growth or address mental health conditions. "Therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a)" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a)" does not include religious counselingReligious counseling"Religious counseling" means counseling provided by clergy members, pastoral counselors, or other religious leaders acting within the scope of their religious duties if the services are explicitly faith-based and are not represented as clinical mental health services or therapy or psychotherapy services.G.L. c. 112, § 298(a) or peer supportPeer support"Peer support" means services provided by individuals with lived experience of mental health conditions or recovery from substance use that are intended to offer encouragement, understanding, and guidance without clinical intervention.G.L. c. 112, § 298(a).
(b) 1 As used in this Section, "permitted use of artificial intelligencePermitted use of artificial intelligence"Permitted use of artificial intelligence" means the use of artificial intelligence tools or systems by a licensed professional to assist in providing administrative support or supplementary support in therapy or psychotherapy services where the licensed professional maintains full responsibility for all interactions, outputs, and data use associated with the system and satisfies the requirements of subsection (c).G.L. c. 112, § 298(b)" means the use of artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) tools or systems by a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) to assist in providing administrative supportAdministrative support"Administrative support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve communication. "Administrative support" includes, but is not limited to, the following: (1) managing appointment scheduling and reminders; (2) processing billing and insurance claims; and (3) drafting general communications related to therapy logistics that do not include therapeutic advice.G.L. c. 112, § 298(a) or supplementary supportSupplementary support"Supplementary support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve therapeutic communication and that are not administrative support. "Supplementary support" includes, but is not limited to, the following: (1) preparing and maintaining client records, including therapy notes; (2) analyzing anonymized data to track client progress or identify trends, subject to review by a licensed professional; and (3) identifying and organizing external resources or referrals for client use.G.L. c. 112, § 298(a) in therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a) where the licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) maintains full responsibility for all interactions, outputs, and data use associated with the system and satisfies the requirements of subsection (c).
Subsections (a) and (b) establish the definitional framework for the bill's regulation of AI in therapy and psychotherapy. The definitions are notably precise: therapeutic communication is broadly defined to encompass virtually all clinical interactions, while administrative support and supplementary support carve out the narrow categories where AI may assist. The consent definition explicitly excludes consent obtained through general terms of use, passive user behavior, or deceptive actions.
Subsection (b) defines the concept of permitted use of artificial intelligence, which limits AI to administrative and supplementary support roles and requires the licensed professional to maintain full responsibility for all interactions, outputs, and data use.
(c) 2 No licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) shall be permitted to use artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) to assist in providing supplementary supportSupplementary support"Supplementary support" means tasks performed to assist a licensed professional in the delivery of therapy or psychotherapy services that do not involve therapeutic communication and that are not administrative support. "Supplementary support" includes, but is not limited to, the following: (1) preparing and maintaining client records, including therapy notes; (2) analyzing anonymized data to track client progress or identify trends, subject to review by a licensed professional; and (3) identifying and organizing external resources or referrals for client use.G.L. c. 112, § 298(a) in therapy or psychotherapy where the client's therapeutic session is recorded or transcribed unless: (1) the patient or the patient's legally authorized representative is informed in writing of the following: (A) that artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) will be used; and (B) the specific purpose of the artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) tool or system that will be used; and (2) the patient or the patient's legally authorized representative provides consentConsent"Consent" means a clear, explicit affirmative act by an individual that: (i) unambiguously communicates the individual's express, freely given, informed, voluntary, specific, and unambiguous written agreement, including a written agreement provided by electronic means, and (ii) is revocable by the individual. "Consent" does not include an agreement that is obtained by the following: (1) the acceptance of a general or broad terms of use agreement or a similar document that contains description of artificial intelligence along with other unrelated information; (2) an individual hovering over, muting, pausing, or closing a given piece of digital content; or (3) an agreement obtained through the use of deceptive actions.G.L. c. 112, § 298(a) to the use of artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a).
Subsection (c) imposes a specific informed consent requirement before a licensed professional may use AI to record or transcribe a therapeutic session. The consent must be written, must inform the patient (or legally authorized representative) that AI will be used and the specific purpose of the AI tool, and must meet the bill's strict definition of consent — which excludes general terms-of-use agreements, passive behavior, and deceptively obtained agreements. Consent is revocable at any time.
(d) 3 An individual, corporation, or entity may not provide, advertise, or otherwise offer therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a), including through the use of Internet-based artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), to the public in this State unless the therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a) are conducted by an individual who is a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a).
Subsection (d) prohibits any individual, corporation, or entity from providing, advertising, or offering therapy or psychotherapy services to the public in Massachusetts — including through Internet-based AI — unless the services are conducted by a licensed professional. This is a broad prohibition that reaches AI companion chatbots, therapy apps, and other AI-driven mental health products that purport to offer therapy without a licensed professional conducting the service.
(e) 4 A licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) may use artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) only to the extent the use meets the requirements of subsections (b) and (c). A licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) may not allow artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) to do any of the following: (1) make independent therapeutic decisions; (2) directly interact with clients in any form of therapeutic communicationTherapeutic communication"Therapeutic communication" means any verbal, non-verbal, or written interaction conducted in a clinical or professional setting that is intended to diagnose, treat, or address an individual's mental, emotional, or behavioral health concerns. "Therapeutic communication" includes, but is not limited to: (1) direct interactions with clients for the purpose of understanding or reflecting their thoughts, emotions, or experiences; (2) providing guidance, therapeutic strategies, or interventions designed to achieve mental health outcomes; (3) offering emotional support, reassurance, or empathy in response to psychological or emotional distress; (4) collaborating with clients to develop or modify therapeutic goals or treatment plans; and (5) offering behavioral feedback intended to promote psychological growth or address mental health conditions.G.L. c. 112, § 298(a); (3) generate therapeutic recommendations or treatment plans without review and approval by the licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a); or (4) detect emotions or mental states.
Subsection (e) enumerates four specific prohibited uses of AI by licensed professionals: (1) making independent therapeutic decisions, (2) directly interacting with clients in therapeutic communication, (3) generating therapeutic recommendations or treatment plans without professional review and approval, and (4) detecting emotions or mental states. These prohibitions apply regardless of any other provision — they are categorical limits on what AI may do in a therapeutic context.
(f) 5 All records kept by a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) and all communications between an individual seeking therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a) and a licensed professionalLicensed professional"Licensed professional" means an individual who holds a valid license issued by this State to provide therapy or psychotherapy services, including: (1) a licensed clinical psychologist; (2) a licensed clinical social worker; (3) a licensed social worker; (4) a licensed professional counselor; (5) a licensed clinical professional counselor; (6) a licensed marriage and family therapist; (7) a certified alcohol and other drug counselor authorized to provide therapy or psychotherapy services; (8) a licensed professional music therapist; (9) a licensed advanced practice registered nurse; and (10) any other professional authorized by this State to provide therapy or psychotherapy services, except for a physician.G.L. c. 112, § 298(a) shall be confidential and shall not be disclosed except as required by law.
Subsection (f) establishes a blanket confidentiality requirement for all records kept by a licensed professional and all communications between an individual seeking therapy or psychotherapy services and a licensed professional. Disclosure is permitted only as required by law. This provision reinforces existing confidentiality obligations but extends them explicitly to the AI-assisted therapy context.
(g) Any individual, corporation, or entity found in violation of this section shall pay a civil penalty to the divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a) in an amount not to exceed $10,000 per violation, as determined by the divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a), with penalties assessed based on the degree of harm and the circumstances of the violation. The civil penalty shall be assessed by the divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a) after a hearing. An individual, corporation, or entity found in violation of this section shall pay the civil penalty within 60 days after the date of an order by the divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a) imposing the civil penalty. The order shall constitute a judgment and may be filed and executed in the same manner as any judgment from a court of record.
(h) The divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a) shall have authority to investigate any actual, alleged, or suspected violation of this Act.
Subsections (g) and (h) establish the enforcement framework for Section 298. The Division of Occupational Licensure may assess civil penalties of up to $10,000 per violation after a hearing, with penalties calibrated to the degree of harm and the circumstances. Penalty orders constitute enforceable judgments. The Division also has authority to investigate actual, alleged, or suspected violations.
(i) This section does not apply to the following: (1) religious counselingReligious counseling"Religious counseling" means counseling provided by clergy members, pastoral counselors, or other religious leaders acting within the scope of their religious duties if the services are explicitly faith-based and are not represented as clinical mental health services or therapy or psychotherapy services.G.L. c. 112, § 298(a); (2) peer supportPeer support"Peer support" means services provided by individuals with lived experience of mental health conditions or recovery from substance use that are intended to offer encouragement, understanding, and guidance without clinical intervention.G.L. c. 112, § 298(a); and (3) self-help materials and educational resources that are available to the public and do not purport to offer therapy or psychotherapy servicesTherapy or psychotherapy services"Therapy or psychotherapy services" means services provided to diagnose, treat, or improve an individual's mental health or behavioral health. "Therapy or psychotherapy services" does not include religious counseling or peer support.G.L. c. 112, § 298(a).
Subsection (i) exempts three categories from Section 298: religious counseling, peer support, and self-help materials and educational resources available to the public that do not purport to offer therapy or psychotherapy services. These exemptions are definitionally tied to the terms defined in subsection (a).
(g)(1)(A)–(B) 6 The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool bases its determination on the following information, as applicable: (i) An insured's medical or other clinical history. (ii) Individual clinical circumstances as presented by the requesting provider. (iii) Other relevant clinical information contained in the insured's medical or other clinical record. (B) The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool does not base its determination solely on a group dataset.
Section 2 amends Chapter 176O § 12 to add subsection (g), which regulates AI, algorithms, and software tools used in utilization review or utilization management. Paragraphs (A) and (B) of subdivision (1) require that AI tools base their determinations on individualized enrollee clinical data — including medical history, individual clinical circumstances as presented by the requesting provider, and other relevant clinical information — and prohibit determinations based solely on group datasets.
(g)(1)(C) The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tools criteria and guidelines complies with this chapter and applicable state and federal law.
(g)(1)(D) 7 The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool does not supplant health care provider decision-making.
(g)(1)(E) 8 The use of the artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool does not discriminate, directly or indirectly, against any insured in violation of state or federal law, including but not limited to chapter 151B.
(g)(1)(F) 8 The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool is fairly and equitably applied, including in accordance with any applicable regulations and guidance issued by state and federal agencies.
Paragraphs (C) through (F) impose four interrelated requirements on AI utilization review tools: compliance with Chapter 176O and applicable state and federal law; a prohibition on supplanting healthcare provider decision-making; a prohibition on direct or indirect discrimination against any insured in violation of state or federal law (including Chapter 151B); and a requirement that the tool be fairly and equitably applied consistent with applicable regulatory guidance.
(g)(1)(G) 9 The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool is open to inspection for audit or compliance reviews by the divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a) and by the executive office of health and human services pursuant to applicable state and federal law.
(g)(1)(H) 10 Disclosures pertaining to the use and oversight of the artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool are contained in the written policies and procedures, as required by subsection (a).
Paragraph (G) requires AI utilization review tools to be open to inspection for audit or compliance reviews by the Division and by the Executive Office of Health and Human Services. Paragraph (H) requires that disclosures about the use and oversight of AI tools be contained in the carrier's written policies and procedures as required by subsection (a) of Chapter 176O § 12.
(g)(1)(I) 11 The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tools performance, use, and outcomes are periodically reviewed and revised to maximize accuracy and reliability.
(g)(1)(J) 12 Patient data is not used beyond its intended and stated purpose, and consistent with state and federal law.
(g)(1)(K) 13 The artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool does not directly or indirectly cause harm to the insured.
Paragraphs (I) through (K) impose three continuing operational requirements: (I) periodic review and revision of AI tool performance, use, and outcomes to maximize accuracy and reliability; (J) a prohibition on using patient data beyond its intended and stated purpose, consistent with state and federal law; and (K) a prohibition on the AI tool directly or indirectly causing harm to the insured.
(g)(2) 14 Notwithstanding paragraph (1), the artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tool shall not deny, delay, or modify health care services based, in whole or in part, on medical necessity. A determination of medical necessity shall be made only by a licensed physician or a licensed health care professional competent to evaluate the specific clinical issues involved in the health care services requested by the provider, as provided in subsection (a), by reviewing and considering the requesting providers recommendation, the insured's medical or other clinical history, as applicable, and individual clinical circumstances.
Paragraph (2) is the bill's strongest healthcare AI restriction: notwithstanding all of paragraph (1), the AI tool itself shall not deny, delay, or modify health care services based on medical necessity. Medical necessity determinations may only be made by a licensed physician or a licensed healthcare professional competent to evaluate the specific clinical issues, who must review the requesting provider's recommendation, the insured's clinical history, and individual clinical circumstances.
(g)(3) For purposes of this subsection, artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a) means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.
(g)(4) This subsection shall apply to utilization review or utilization management functions that prospectively, retrospectively, or concurrently review requests for covered health care services.
(g)(5) A health benefit plan subject to this subsection shall comply with applicable state and federal rules and guidance regarding the use of artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tools. The divisionDivision"Division" means the Division of Occupational Licensure.G.L. c. 112, § 298(a) and the executive office of health and human services may issue guidance to implement this paragraph within one year of the adoption of state or federal rules or the issuance of guidance by the federal Department of Health and Human Services regarding the use of artificial intelligenceArtificial intelligence"Artificial intelligence" means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.G.L. c. 112, § 298(a), algorithm, or other software tools. Such guidance shall not be subject to chapter 30A.
(g)(6) This subsection applies to a MassHealth managed health benefit plan only to the extent that the executive office of health and human services obtains any necessary federal approvals, and federal financial participation is not otherwise jeopardized.
(g)(7) This subsection shall apply to an insured regardless of the residency of the individual.
(g)(8) A violation of this subsection constitutes an injury to the insured. The insured may bring a civil action against the party that commits the violation. In a civil action brought under this subsection in which an insured prevails, the court may award the plaintiff: (A) Damages in an amount not more than $5,000 per insured per violation or actual damages, whichever is greater; (B) punitive damages; (C) injunctive relief; and (D) reasonable attorney's fees and litigation costs.
Paragraphs (3) through (8) contain the section's definitional, scope, and enforcement provisions. Paragraph (3) defines artificial intelligence for purposes of this subsection. Paragraph (4) clarifies that the subsection applies to prospective, retrospective, and concurrent utilization review. Paragraph (5) requires compliance with applicable state and federal AI guidance and authorizes the Division and EOHHS to issue implementing guidance. Paragraph (6) limits application to MassHealth managed plans contingent on federal approvals. Paragraph (7) extends coverage to all insureds regardless of residency. Paragraph (8) creates a private right of action with damages up to $5,000 per insured per violation or actual damages (whichever is greater), plus punitive damages, injunctive relief, and attorney's fees.