Bill S.405

SENATE DOCKET, NO. 301 FILED ON: 1/19/2011

SENATE . . . . . . . . . . . . . . No. 405

By Mr. Brewer, a petition (accompanied by bill, Senate, No. 405) of Stephen M. Brewer for legislation to mandate coverage for ectodermal dysplasia. Financial Services.

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 449 OF 2009-2010.]

The Commonwealth of Massachusetts

_______________

In the Year Two Thousand Eleven

_______________

An Act mandating coverage for ectodermal dysplasia and other congenital disorders..

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 17E of chapter 32A of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting after the words "result of", in lines 10 and 11, the following words:- ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities or.

SECTION 2. Said chapter 32A is hereby amended by inserting after section 17H the following section:-

Section 17I. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for dentures, dental implants, crowns and bridges that are medically necessary for the care and treatment of ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities.

SECTION 3. Section 47T of chapter 175 of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting after the words "result of", in line 20, the following words:- ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities or.

SECTION 4. Said chapter 175 is hereby amended by inserting after section 47X, inserted by section 1 of chapter 49 of the acts of 2004, the following section:-

Section 47Y. Any individual policy of accident and sickness insurance issued pursuant to section 108 and any group blanket policy of accident and sickness insurance issued pursuant to section 110, except policies providing supplemental coverage to Medicare or to other government programs, that is delivered, issued or renewed within or without the commonwealth shall provide coverage for dentures, dental implants, crowns and bridges that are medically necessary for the care and treatment of ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities.

SECTION 5. Section 8T of chapter 176A of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting after the words "result of", in line 15, the following words:- ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities or.

SECTION 6. Said chapter 176A is hereby amended by inserting after section 8Y, inserted by section 2 of chapter 49 of the acts of 2004, the following section:-

Section 8Z. Any contract between a subscriber and the corporation under an individual or group hospital service plan, except contracts providing supplemental coverage to Medicare or to other government programs, that is delivered, issued or renewed within or without the commonwealth shall provide 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 dentures, dental implants, crowns and bridges that are medically necessary for the care and treatment of ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities.

SECTION 7. Section 4R of chapter 176B of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting after the word "result of", in line 15, the following words:- ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities or.

SECTION 8. Said chapter 176B is hereby amended by inserting after section 4Y, inserted by section 3 of chapter 49 of the acts of 2002, the following section:-

Section 4Z. Any subscription certificate under an individual or group medical service agreement, except certificates providing supplemental coverage to Medicare or to other government programs, that is delivered, issued or renewed within or without the commonwealth shall provide 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 dentures, dental implants, crowns and bridges that are medically necessary for the care and treatment of ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities.

SECTION 9. Section 4J of chapter 176G of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting after the words "result of", in line 9, the following words:- ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities or.

SECTION 10. Said chapter 176G is hereby amended by inserting after section 4Q, inserted by section 4 of chapter 49 of the Acts of 2002, the following section:-

Section 4R. Any individual or group health maintenance contract, except contracts providing supplemental coverage to Medicare or to other government programs, that is issued, renewed or delivered within or without the commonwealth shall provide to residents of the commonwealth and to persons having a principal place of employment within the commonwealth coverage for dentures, dental implants, crowns and bridges that are medically necessary for the care and treatment of ectodermal dysplasia, cleft lip, cleft palate, dentinogenesis imperfecta, amelogenesis imperfecta and other maxillofacial abnormalities.

SECTION 11. This act shall apply to all policies, contracts, agreements, plans and certificates of insurance issued or delivered within or without the commonwealth on or after January 1, 2010, and to all policies, contracts, agreements, plans and certificates of insurance in effect before that date upon renewal on or after January 1, 2010.

Name:	District/Address:
Stephen M. Brewer	Worcester, Hampden, Hampshire and Middlesex