HOUSE DOCKET, NO. 2683        FILED ON: 1/20/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2201

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Daniel J. Ryan

_________________

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 qualified health plans.

_______________

PETITION OF:

 

Name:

District/Address:

Date Added:

Daniel J. Ryan

2nd Suffolk

1/20/2017

Sal N. DiDomenico

Middlesex and Suffolk

 


HOUSE DOCKET, NO. 2683        FILED ON: 1/20/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2201

By Mr. Ryan of Boston, a petition (accompanied by bill, House, No. 2201) of Daniel J. Ryan and Sal N. DiDomenico relative to exemptions for certain reduced or selective network health insurance plans.  Financial Services.

 

The Commonwealth of Massachusetts

 

_______________

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

_______________

 

An Act relative to qualified health plans.

 

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 11 of Chapter 176J of the General Laws, as so appearing in the 2014 Official Edition, is hereby amended by inserting after the last paragraph in subsection (a) the following paragraph:-

The commissioner may also exempt carriers from complying with this section based on: (i) whether the carrier’s service area is already reduced such that the carrier is not certified to issue coverage in all rating regions; or (ii) whether the carrier maintains a network of providers that is already constrained such that the carrier only contracts with a selective network of providers; or (iii) whether the variation in provider reimbursement rates for a majority of providers within the carrier’s network that account for the greatest volume of services is constrained to less than 14 per cent variation; or (iv) whether the majority of the carrier’s chapter 176J membership is enrolled in subsidized coverage offered under chapter 176Q through which such members receive state or federal subsidies; or (v) whether the carrier receives 80 per cent or more of its income from government programs, including subsidized coverage offered under chapter 176Q through which such members receive state or federal subsidies; or (vi) any other factor that impacts whether the carrier is reasonably able to comply with this section.