HOUSE DOCKET, NO. 3391 FILED ON: 1/16/2015
HOUSE . . . . . . . . . . . . . . . No. 3488
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The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Sean Garballey
_________________
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 providing for certain health insurance coverage.
_______________
PETITION OF:
Name: | District/Address: | Date Added: |
Sean Garballey | 23rd Middlesex | 1/16/2015 |
Paul J. Donato | 35th Middlesex | 8/6/2019 |
Sarah K. Peake | 4th Barnstable | 8/6/2019 |
David M. Nangle | 17th Middlesex | 8/6/2019 |
Carolyn C. Dykema | 8th Middlesex | 8/6/2019 |
John C. Velis | 4th Hampden | 8/6/2019 |
Brendan P. Crighton | 11th Essex | 8/6/2019 |
Jay R. Kaufman | 15th Middlesex | 8/6/2019 |
James J. Dwyer | 30th Middlesex | 8/6/2019 |
Paul McMurtry | 11th Norfolk | 8/6/2019 |
Kay Khan | 11th Middlesex | 8/6/2019 |
Jennifer E. Benson | 37th Middlesex | 2/3/2015 |
Marjorie C. Decker | 25th Middlesex | 8/6/2019 |
Leah Cole | 12th Essex | 8/6/2019 |
Kevin G. Honan | 17th Suffolk | 8/6/2019 |
David M. Rogers | 24th Middlesex | 8/6/2019 |
Chris Walsh | 6th Middlesex | 8/6/2019 |
Denise Provost | 27th Middlesex | 8/6/2019 |
Angelo M. Scaccia | 14th Suffolk | 8/6/2019 |
Christine P. Barber | 34th Middlesex | 8/6/2019 |
Jonathan D. Zlotnik | 2nd Worcester | 8/6/2019 |
Tricia Farley-Bouvier | 3rd Berkshire | 8/6/2019 |
Tom Sannicandro | 7th Middlesex | 8/6/2019 |
Gailanne M. Cariddi | 1st Berkshire | 8/6/2019 |
Jay D. Livingstone | 8th Suffolk | 8/6/2019 |
Mary S. Keefe | 15th Worcester | 8/6/2019 |
Tackey Chan | 2nd Norfolk | 8/6/2019 |
John H. Rogers | 12th Norfolk | 8/6/2019 |
Carmine L. Gentile | 13th Middlesex | 8/6/2019 |
Daniel M. Donahue | 16th Worcester | 8/6/2019 |
Harold P. Naughton, Jr. | 12th Worcester | 8/6/2019 |
Denise C. Garlick | 13th Norfolk | 8/6/2019 |
Jonathan Hecht | 29th Middlesex | 8/6/2019 |
John J. Lawn, Jr. | 10th Middlesex | 8/6/2019 |
Thomas M. Stanley | 9th Middlesex | 8/6/2019 |
Walter F. Timilty | 7th Norfolk | 8/6/2019 |
Timothy J. Toomey, Jr. | 26th Middlesex | 8/6/2019 |
Benjamin Swan | 11th Hampden | 8/6/2019 |
Brian M. Ashe | 2nd Hampden | 8/6/2019 |
Bruce J. Ayers | 1st Norfolk | 8/6/2019 |
James J. O'Day | 14th Worcester | 8/6/2019 |
HOUSE DOCKET, NO. 3391 FILED ON: 1/16/2015
HOUSE . . . . . . . . . . . . . . . No. 3488
By Mr. Garballey of Arlington, a petition (accompanied by bill, House, No. 3488) of Sean Garballey and others relative to providing certain health insurance coverage. Public Service. |
The Commonwealth of Massachusetts
_______________
In the One Hundred and Eighty-Ninth General Court
(2015-2016)
_______________
An Act providing for certain health insurance coverage.
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 17A of chapter 32A of the General Laws, as appearing in the 2012 Official Edition, is hereby amended by striking out the first sentence and inserting in place thereof the following 4 sentences:-
The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the cost of enteral formulas for home use, whether administered orally or via tube feeding, for which a physician has issued a written order. Such written order shall state that the enteral formula is clearly medically necessary and has been proven effective as a disease-specific treatment regimen for those individuals who are or will become malnourished or suffer from disorders, which if left untreated, cause chronic physical or intellectual disability or death. Specific diseases for which enteral formulas have been proven effective shall include, but are not limited to, inherited diseases of amino acid or organic acid metabolism; eosinophilic gastrointestinal disorders; Crohn's Disease; gastroesophageal reflux with failure to thrive; disorders of gastrointestinal motility such as chronic intestinal pseudo-obstruction; and multiple, severe food allergies, which if left untreated will cause malnourishment, chronic physical or intellectual disability or death. Enteral formulas which are medically necessary and taken under written order from a physician for the treatment of specific diseases shall be distinguished from nutritional supplements taken electively.
SECTION 2. Section 47I of chapter 175 of the General Laws, as so appearing, is hereby amended by striking out the first sentence and inserting in place thereof the following 4 sentences:-
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, shall provide coverage for the cost of enteral formulas for home use, whether administered orally or via tube feeding, for which a physician has issued a written order. Such written order shall state that the enteral formula is clearly medically necessary and has been proven effective as a disease-specific treatment regimen for those individuals who are or will become malnourished or suffer from disorders, which if left untreated, cause chronic physical or intellectual disability or death. Specific diseases for which enteral formulas have been proven effective shall include, but are not limited to, inherited diseases of amino acid or organic acid metabolism; eosinophilic gastrointestinal disorders; Crohn's Disease; gastroesophageal reflux with failure to thrive; disorders of gastrointestinal motility such as chronic intestinal pseudo-obstruction; and multiple, severe food allergies, which if left untreated will cause malnourishment, chronic physical or intellectual disability or death. Enteral formulas which are medically necessary and taken under written order from a physician for the treatment of specific diseases shall be distinguished from nutritional supplements taken electively.
SECTION 3. Section 8L of chapter 176A of the General Laws, as so appearing, is hereby amended by striking out the first sentence and inserting in place thereof the following 4 sentences:-
Any contract between a subscriber and the corporation under an individual or group hospital service plan that shall be delivered, issued or renewed in the commonwealth shall provide, as benefits to all individual subscribers and members within the commonwealth, coverage for the cost of enteral formulas for home use, whether administered orally or via tube feeding, for which a physician has issued a written order. Such written order shall state that the enteral formula is clearly medically necessary and has been proven effective as a disease-specific treatment regimen for those individuals who are or will become malnourished or suffer from disorders, which if left untreated, cause chronic physical or intellectual disability or death. Specific diseases for which enteral formulas have been proven effective shall include, but are not limited to, inherited diseases of amino acid or organic acid metabolism; eosinophilic gastrointestinal disorders; Crohn's Disease; gastroesophageal reflux with failure to thrive; disorders of gastrointestinal motility such as chronic intestinal pseudo-obstruction; and multiple, severe food allergies, which if left untreated will cause malnourishment, chronic physical or intellectual disability or death. Enteral formulas which are medically necessary and taken under written order from a physician for the treatment of specific diseases shall be distinguished from nutritional supplements taken electively.
SECTION 4. Section 4K of chapter 176B of the General Laws, as so appearing, is hereby amended by striking out the first sentence and inserting in place thereof the following 4 sentences:-
Any subscription certificate under an individual or group medical service agreement that shall be delivered, issued or renewed in the commonwealth shall provide, as benefits to all individual subscribers and members within the commonwealth, all group members having a principal place of employment within the commonwealth and all persons included in section 4C, coverage for the cost of enteral formulas for home use, whether administered orally or via tube feeding, for which a physician has issued a written order. Such written order shall state that the enteral formula is clearly medically necessary and has been proven effective as a disease-specific treatment regimen for those individuals who are or will become malnourished or suffer from disorders, which if left untreated, cause chronic physical or intellectual disability or death. Specific diseases for which enteral formulas have been proven effective shall include, but are not limited to, inherited diseases of amino acid or organic acid metabolism; eosinophilic gastrointestinal disorders; Crohn's Disease; gastroesophageal reflux with failure to thrive; disorders of gastrointestinal motility such as chronic intestinal pseudo-obstruction; and multiple, severe food allergies, which if left untreated will cause malnourishment, chronic physical or intellectual disability or death. Enteral formulas which are medically necessary and taken under written order from a physician for the treatment of specific diseases shall be distinguished from nutritional supplements taken electively.
SECTION 5. Section 4D of chapter 176G of the General Laws, as so appearing, is hereby amended by striking out the first sentence and inserting in place thereof the following 4 sentences:-
A group health maintenance contract shall provide coverage for the cost of enteral formulas for home use, whether administered orally or via tube feeding, for which a physician has issued a written order. Such written order shall state that the enteral formula is clearly medically necessary and has been proven effective as a disease-specific treatment regimen for those individuals who are or will become malnourished or suffer from disorders, which if left untreated, cause chronic physical or intellectual disability or death. Specific diseases for which enteral formulas have been proven effective shall include, but are not limited to, inherited diseases of amino acid or organic acid metabolism; eosinophilic gastrointestinal disorders; Crohn's Disease; gastroesophageal reflux with failure to thrive; disorders of gastrointestinal motility such as chronic intestinal pseudo-obstruction; and multiple, severe food allergies, which if left untreated will cause malnourishment, chronic physical or intellectual disability or death. Enteral formulas which are medically necessary and taken under written order from a physician for the treatment of specific diseases shall be distinguished from nutritional supplements taken electively.