Bill H.2065

HOUSE DOCKET, NO. 2754 FILED ON: 1/21/2011

HOUSE . . . . . . . . . . . . . . . No. 2065

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Louis L. Kafka

_________________

To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to the treatment of cleft palate and cleft lip.

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PETITION OF:

Name:	District/Address:	Date Added:
Louis L. Kafka	8th Norfolk	1/21/2011
John W. Scibak	2nd Hampshire	2/1/2011
Jennifer E. Benson	37th Middlesex	2/1/2011
George T. Ross	2nd Bristol	2/1/2011
Theodore C. Speliotis	13th Essex	2/1/2011
Peter V. Kocot	1st Hampshire	2/1/2011
Cory Atkins	14th Middlesex	2/1/2011
Anne M. Gobi	5th Worcester	2/4/2011
Stephen R. Canessa	12th Bristol	2/4/2011
David Paul Linsky	5th Middlesex	2/4/2011
Timothy R. Madden	Barnstable, Dukes and Nantucket	2/4/2011
James Arciero	2nd Middlesex	2/4/2011
Geraldine M. Creedon	11th Plymouth	2/4/2011
Kimberly N. Ferguson	1st Worcester	2/4/2011
Thomas M. Stanley	9th Middlesex	2/4/2011
Denise Provost	27th Middlesex	2/4/2011
Christine E. Canavan	10th Plymouth	2/4/2011
Garrett J. Bradley	3rd Plymouth	2/4/2011
Kathi-Anne Reinstein	16th Suffolk	2/4/2011
James M. Cantwell	4th Plymouth	2/4/2011
David M. Torrisi	14th Essex	2/4/2011
Eileen M. Donoghue		2/4/2011
Denise Andrews	2nd Franklin	2/4/2011
James B. Eldridge		2/4/2011
William C. Galvin	6th Norfolk	1/21/2011
Jonathan Hecht	29th Middlesex	2/3/2011
James E. Timilty		1/25/2011

HOUSE DOCKET, NO. 2754 FILED ON: 1/21/2011

HOUSE . . . . . . . . . . . . . . . No. 2065

By Mr. Kafka of Stoughton, a petition (accompanied by bill, House, No. 2065) of Louis L. Kafka and others relative to health insurance policies requirements to provide coverage for the treatment of children with cleft lips and palates. Financial Services.

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 932 OF 2009-2010.]

The Commonwealth of Massachusetts

_______________

In the Year Two Thousand Eleven

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An Act relative to the treatment of cleft palate and cleft lip.

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 32A of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by adding the following section:

Section 17J. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 2. Chapter 118E, is hereby amended by adding the following section:

Section 61. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 3. Section 108 of Chapter 175 is hereby amended by adding the following section:

Section K. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 4. Section 110 of Chapter 175 is hereby amended by adding the following section:

Section N. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 5. Chapter 176A of the General Laws is hereby amended by adding the following section:

Section 8CC. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 6. Chapter 176B of the General Laws is hereby amended by adding the following section:

Section 4CC. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 7. Chapter 176G of the General Laws is hereby amended by adding the following section:

Section 4U. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.

SECTION 8. Chapter 176I of the General Laws is hereby amended by adding the following section:

Section 12. Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate. The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision.