HOUSE DOCKET, NO. 1106        FILED ON: 1/14/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 861

The Commonwealth of Massachusetts

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PRESENTED BY:

Colleen M. Garry

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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 relative to access to care for Ehler Danlos syndrome patients.

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PETITION OF:

HOUSE DOCKET, NO. 1106        FILED ON: 1/14/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 861

The Commonwealth of Massachusetts

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In the One Hundred and Eighty-Ninth General Court
(2015-2016)

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An Act relative to access to care for Ehler Danlos syndrome patients.

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 2012 Official Edition, is hereby amended by inserting after section 17K the following section:-

Section 17L. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission that provides coverage for cancer chemotherapy treatment shall provide coverage for physical therapy preventative, ongoing chronic maintenance, acute treatment for Ehler Danlos Syndrome patients.

SECTION 2. Chapter 175 of the General Laws, as so appearing, is hereby amended by inserting after section 47DD, the following section:-

Section 47EE. Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides medical expense coverage shall provide for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results or response to therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.

SECTION 3. Chapter 176A of the General Laws, as so appearing, is hereby amended by inserting after section 8FF the following section:-

Section 8GG. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall provide coverage for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results or response to therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.

SECTION 4. Chapter 176B of the General Laws, as so appearing, is hereby amended by inserting after section 4FF, the following section:-

Section 4GG. Any subscription certificate under an individual or group medical service agreement delivered, issued, or renewed within the Commonwealth shall provide coverage for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results and  response in therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.

SECTION 5. Chapter 176G of the General Laws, as so appearing, is hereby amended by inserting after section 4X the following section:-

Section 4Y. Any individual or group health maintenance contract shall provide coverage for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results and  response in therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.