HOUSE DOCKET, NO. 320        FILED ON: 1/14/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 316

The Commonwealth of Massachusetts

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PRESENTED BY:

Kathi-Anne Reinstein

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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 further regulating insurance benefits..

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PETITION OF:

HOUSE DOCKET, NO. 320        FILED ON: 1/14/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 316

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 1020 OF 2009-2010.]

The Commonwealth of Massachusetts

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In the Year Two Thousand Eleven

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An Act further regulating insurance benefits..

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 1 of chapter 176G of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by striking out the definition of “Health services” in lines 78 to 81 and inserting in place thereof the following definition:—

“Health Services”,    at least reasonably comprehensive physician services on a nondiscriminatory basis, inpatient and outpatient services, emergency health services, chiropractic and podiatric services.

SECTION 2.  Said section 1 of said chapter is hereby further amended by striking out the definition of “Nondiscriminatory” in lines  95 to 100 and inserting in place thereof the following definition:-

“Nondiscriminatory,”   any individual who has entered into a group health maintenance contract that provides for any chiropractic, podiatric, medical or surgical service which is within the lawful scope of practice of a licensed podiatrist, or chiropractor shall be entitled to such services whether the service is performed by a physician, chiropractor or licensed podiatrist including authorized referral services on a nondiscriminatory basis.

SECTION 3. Chapter 176G of the General Laws, as appearing in the 2004 Official Edition, and amended by section 11 of chapter 172 of the acts of 2006, is hereby further amended by adding the following new sections: —

Section 4S. Every registered chiropractor shall have the right, on complying with such rules and regulations the organization may make, to enter into written agreement with a health maintenance organization, doing business in the city or town where the  chiropractor resides or has a usual place of business, to perform chiropractic services. No restrictions shall be placed by any such health maintenance organization upon its participating chiropractors as to methods of diagnosis or treatment. No officer, agent or employee of a health maintenance organization shall influence or attempt to influence a subscriber or a covered dependent in the choice of a participating chiropractor. Nothing in this section shall be construed to prohibit any health maintenance organization from entering into written agreements with its subscribers and with participating chiropractors to furnish chiropractic services to subscribers and covered dependents or from including chiropractic services in its health services plan nor shall any health maintenance organization discriminate in any way against participating chiropractors in the furnishing of chiropractic services to its subscribers and covered dependents.

Section 4T.   Upon the request of a subscriber or covered dependent for chiropractic services, the health maintenance organization shall refer the subscriber or covered dependent to a participating doctor of chiropractic in the geographical area nearest to the subscriber’s or covered dependent’s residence. Benefit levels for health care services rendered by non-participating providers shall be at least 80% of the benefit levels for services rendered by participating providers.