HOUSE DOCKET, NO. 1045        FILED ON: 1/15/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 997

The Commonwealth of Massachusetts

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PRESENTED BY:

Martin J. Walsh

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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 promoting consumer choice in health care.

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PETITION OF:

HOUSE DOCKET, NO. 1045        FILED ON: 1/15/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 997

The Commonwealth of Massachusetts

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In the Year Two Thousand Thirteen

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An Act promoting consumer choice in health care.

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

Chapter 175 of the General Laws is hereby amended by adding at the end of said Chapter the following section:

SECTION__A licensed athletic trainer, acting with a referral from a physician, who acts within the scope of practice authorized by law shall not be denied reimbursement by the health insurer for those covered services if the health insurer would reimburse another health care provider for those services. This Section pertains only to those health plans that provide coverage for a particular type of health service, or for any particular medical condition that is within the scope of practice of licensed athletic trainers.

Services provided by licensed athletic trainers may be subject to reasonable deductibles, co-payment and co-insurance amounts, fee or benefit limits, practice parameters, and utilization review consistent with applicable rules adopted by the Division of Insurance; provided that the amounts, limits, and review shall not function to direct treatment in a manner unfairly discriminative against athletic trainer care, and collectively shall be no more restrictive than those applicable under the same policy for care or services provided by other health care providers.

Nothing in this Section shall be construed as impeding or preventing either the provision or coverage of health care services by licensed athletic trainers within the lawful scope of athletic trainer practice.

As used in this section, “health insurance plan” means an individual or group health insurance policy, a hospital or medical service corporation or health maintenance organization subscriber contract, or another health benefit plan offered, issued, or renewed for a person by a health insurer. The term shall not include benefit plans providing coverage for specific disease or other limited benefit coverage.