Session Laws

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Section 47C of chapter 175 of the General Laws, as appearing in the 1988 Official Edition, is hereby amended by adding the following paragraph:-

The dependent coverage of any such policy shall also provide coverage for medically necessary early intervention services including occupational, physical and speech therapy, nursing care and psychological counseling. Such medically necessary services shall be provided by persons licensed under the provisions of chapter one hundred and twelve, who are working in early intervention programs approved by the department of public health, as defined in sections one and two of chapter one hundred and eleven G, for children from birth until three months after their third birthday or until September first of the year of the recipient's third birthday if the recipient was born after April first. Reimbursement of costs for such services shall be part of a basic benefits package offered by the insurer or third party, with a maximum benefit of two thousand four hundred dollars per year per child and an aggregate benefit of eight thousand dollars over the total enrollment period.

SECTION 2. Section 8B of chapter 176A of the General Laws, as so appearing, is hereby amended by adding the following paragraph:-

The dependent coverage of any such policy shall also provide coverage for medically necessary early intervention services including occupational, physical and speech therapy, nursing care and psychological counseling; provided, however, that such dependent coverage for early intervention services shall be included in individual medical service agreements delivered, issued or renewed on or after January first, nineteen hundred and ninety-one. Such medically necessary services shall be provided by persons licensed under the provisions of chapter one hundred and twelve who are working in early intervention programs approved by the department of public health, as defined in sections one and two of chapter one hundred and eleven G, for children from birth until three months after their third birthday or until September first of the year of the recipient's third birthday if the recipient was born after April first. Reimbursement of costs for such services shall be part of a basic benefits package offered by the insurer or third party, with a maximum benefit of two thousand four hundred dollars per year per child and an aggregate benefit of eight thousand dollars over the total enrollment period.

SECTION 3. Section 4C of chapter 176B of the General Laws, as appearing, is hereby amended by adding the following paragraph:-

The dependent coverage of any such policy shall also provide coverage for medically necessary early intervention services including occupational, physical and speech therapy, nursing care and psychological counseling; provided, however, that such dependent coverage for early intervention services shall be included in individual medical service agreements delivered, issued or renewed on or after January first, nineteen hundred and ninety-one. Such medically necessary services shall be provided by persons licensed under the provisions of chapter one hundred and twelve, who are working in early intervention programs approved by the department of public health, as defined and described in sections one and two of chapter one hundred and eleven G, for children from birth until three months after their third birthday or until September first of the year of the recipient's third birthday if the recipient was born after April first. Reimbursement of costs for such services shall be part of a basic benefits package offered by the insurer or third party, with a maximum benefit of two thousand four hundred dollars per year per child and an aggregate benefit of eight thousand dollars over the total enrollment period.

SECTION 4. Section 4 of chapter 176G of the General Laws, as so appearing is hereby amended by adding the following paragraph:-

The dependent coverage of any such policy shall also provide coverage to eligible persons for appropriate medically necessary early intervention services including occupational, physical and speech therapy, nursing care and psychological counseling; provided, however, that the determination of appropriate medical necessity shall be made by the dependent's primary care physician. In making such a determination, the primary care physician shall consider the assessment of an interdisciplinary team operating within an early intervention program approved by the department of public health, as defined and described in sections one and two of chapter one hundred and eleven G. Such appropriate medically necessary services shall be provided by persons licensed under chapter one hundred and twelve who are working in early intervention programs that meet standards established by the department of public health, to children from birth until three months after their third birthday or until September first of the year of the recipient's third birthday if the recipient was born after April first. Reimbursement of costs for such services shall be part of a basic benefits package offered by the insurer or third party, with a maximum benefit of two thousand four hundred dollars per year per child and an aggregate benefit of eight thousand dollars over the total enrollment period.