HOUSE DOCKET, NO. 2332        FILED ON: 1/19/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2169

The Commonwealth of Massachusetts

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PRESENTED BY:

Denise C. Garlick

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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 osteoporosis screening and treatment to prevent fractures and reduce health care costs.

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PETITION OF:

HOUSE DOCKET, NO. 2332        FILED ON: 1/19/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2169

The Commonwealth of Massachusetts

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In the One Hundred and Ninetieth General Court
(2017-2018)

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An Act relative to osteoporosis screening and treatment to prevent fractures and reduce health care costs.

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. Postmenopausal women aged 50 and older shall undergo clinical assessment for osteoporosis and fracture risk, including a detailed history and physical examination using tools such as the World Health Organization’s (WHO) clinical fracture risk assessment (FRAX®), when available. Postmenopausal women aged 65 and older, men aged 70 years and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, shall be screened for osteoporosis through bone mineral density (BMD) testing as recommended by the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology and the Endocrine Society guidelines in order to diagnose and determine the degree of osteoporosis.  

Postmenopausal women diagnosed with osteoporosis shall receive treatment for osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention.

SECTION 2. Chapter 32A of the General Laws is hereby amended by inserting after section 17N, as appearing in the 2014 Official Edition, the following section:-

Section 17O. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide coverage for American Association of Clinical Endocrinologists/American College of Endocrinology and Endocrine society guidelines for Bone Mineral Density (BMD) testing in postmenopausal women age 65 years and older, men age 70 and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, to diagnose and determine the degree of osteoporosis; and treatment for postmenopausal women diagnosed with osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the commission.

SECTION 2. Chapter 118E of the General Laws is hereby amended by inserting after section 10I, inserted by section 105 of chapter 46 of the acts of 2015, the following section:-

Section 10J. The division shall provide coverage for American Association of Clinical Endocrinologists/American College of Endocrinology and Endocrine society guidelines for Bone Mineral Density (BMD) testing in postmenopausal women age 65 years and older, men age 70 and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, to diagnose and determine the degree of osteoporosis; and treatment for post-menopausal women diagnosed with osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention.  The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the division.

SECTION 3. Chapter 175 of the General Laws is hereby amended by inserting after section 47GG, as appearing in the 2014 Official Edition, the following section:-

Section 47HH. The following shall provide coverage for American Association of Clinical Endocrinologists/American College of Endocrinology and Endocrine society guidelines for Bone Mineral Density (BMD) testing in postmenopausal women age 65 years and older, men age 70 and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, to diagnose and determine the degree of osteoporosis; and treatment for postmenopausal women diagnosed with osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention: (i) any policy of accident and sickness insurance, as described in section 108, which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and policyholder in the commonwealth; (ii) any blanket or general policy of insurance described in subdivision (A), (C) or (D) of section 110 which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and the policyholder in or outside of the commonwealth; or (iii) any employees’ health and welfare fund which provides hospital expense and surgical expense benefits and which is delivered, issued or renewed to any person or group of persons in the commonwealth. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the insurer.

SECTION 4. Chapter 176A of the General Laws is hereby amended by inserting after section 8II, as so appearing, the following section:-

Section 8JJ. 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 American Association of Clinical Endocrinologists/American College of Endocrinology and Endocrine society guidelines for Bone Mineral Density (BMD) testing in postmenopausal women age 65 years and older, men age 70 and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, to diagnose and determine the degree of osteoporosis; and treatment for post-menopausal women diagnosed with osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the insurer.

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

Section 4JJ. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for American Association of Clinical Endocrinologists/American College of Endocrinology and Endocrine society guidelines for Bone Mineral Density (BMD) testing in postmenopausal women age 65 years and older, men age 70 and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, to diagnose and determine the degree of osteoporosis; and treatment for post-menopausal women diagnosed with osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention.  The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the insurer.

SECTION 6. Chapter 176G of the General Laws is hereby amended by inserting after section 4AA, as so appearing, the following section:-

Section 4BB. Any individual or group health maintenance contract shall provide coverage for American Association of Clinical Endocrinologists/American College of Endocrinology and Endocrine society guidelines for Bone Mineral Density (BMD) testing in postmenopausal women age 65 years and older, men age 70 and older, younger postmenopausal women and high risk men aged 50 years and older at increased risk for bone loss and fracture, based on fracture risk analysis, to diagnose and determine the degree of osteoporosis; and treatment for post-menopausal women diagnosed with osteoporosis in accordance with the recommendations of the American Association of Clinical Endocrinology, including but not limited to pharmacologic anabolic intervention.  The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the insurer.