SENATE DOCKET, NO. 462 FILED ON: 1/13/2009
SENATE . . . . . . . . . . . . . . No. 464
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The Commonwealth of Massachusetts
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In the Year Two Thousand Nine
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An Act to Mandate Insurance Coverage For Bone Mass Measurement Testing For The Diagnosis Of Osteoporosis..
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. Chapter 175 of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by inserting after section 47Z the following section:-
Section 47AA. Any blanket or general policy of insurance described in subdivision (A), (C), or (D) of section one hundred and ten which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, during the period within which this premium is effective, or any policy of accident or sickness insurance as described in section one hundred and eight which provides hospital expense and surgical expense insurance and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth, during the period within which this provision is effective, or any employers' health and welfare fund which provides hospital expense and surgical expense benefits and which is issued or renewed to any person or group of persons in the commonwealth, during the period within which this provision is effective,
shall provide coverage to residents of the commonwealth for bone densitometry, including but not limited to single photon absorptiometry, dual photon absorptiometry and dual x-ray absorptiometry. Said benefits shall be provided in accordance with rules and regulations promulgated by the commissioner of insurance in consultation with the commissioner of public health.
SECTION 2. Chapter 176A of the General laws, as appearing in the 2006 Official Edition, is hereby amended by inserting after section 8AA the following section:-
Section 8AB. Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual group hospital service plan which shall be delivered, issued or renewed in the commonwealth shall provide, as a basic benefit to all individual subscribers and members within the commonwealth and to all group members having a principal place of employment within the commonwealth, coverage for bone densitometry, including but not limited to single photon absorptiometry, dual photon absorptiometry and dual x-ray absorptiometry. Said benefits shall be provided in accordance with rules and regulations promulgated by the commissioner of insurance in consultation with the commissioner of public health.
SECTION 3. Chapter 176B of the General laws, as appearing in the 2006 Official Edition, is hereby amended by inserting after section 4AA the following section:-
Section 4AB. Any subscription certificate under an individual or group medical service agreement, except certificates which provide supplemental coverage to Medicare or other governmental programs, which shall be delivered or issued or renewed in the commonwealth shall provide as benefits to all individual subscribers and members within the commonwealth and to all group members having a principal place of employment within the commonwealth, coverage for bone densitometry, including but not limited to single photon absorptiometry, dual photon absorptiometry and dual x-ray absorptiometry. Said benefits shall be provided in accordance with rules and regulations promulgated by the commissioner of insurance in consultation with the commissioner of public health.
SECTION 4. The first paragraph of section 4 of chapter 176G of the General laws, as appearing in the 2006 Official Edition, is hereby amended by inserting after the last sentence on line 26 the following sentence:-
“Such health maintenance contract shall also provide coverage for medically necessary bone densitometry as set forth in section forty-seven AA of chapter one hundred and seventy-five.”
SECTION 5. The commissioner of insurance, in consultation with the commissioner of public health, shall promulgate rules and regulations under the authority of sections 47AA of chapter 175, section 8AB of chapter 176A, section 4AB of chapter 176B, setting forth requirements and conditions of coverage for bone densitometry; requirements and conditions of coverage shall include: (a) for women who have falling estrogen levels, and who are not already using estrogen replacement therapy, coverage shall include the expense of two bone density tests in a lifetime provided that no other clinical indications of rapid bone loss arise, in which case coverage shall not be limited, but shall be provided as necessary; and (b) coverage shall be provided as necessary for patients who are diagnosed with a clinical condition, other than a falling estrogen level, which indicates rapid bone loss. In setting such requirements and conditions with respect to conditions other than a falling estrogen level which indicate rapid bone loss, the commissioner of insurance shall review the recommendations of the National Osteoporosis Foundation. Said rules and regulations shall be promulgated in accordance with the requirements of sections two through six of chapter thirty A.