HOUSE DOCKET, NO. 3059        FILED ON: 1/20/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2960

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Kate Hogan

_________________

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 to protect access to confidential healthcare.

_______________

PETITION OF:

 

Name:

District/Address:

Date Added:

Kate Hogan

3rd Middlesex

1/20/2017

Patricia A. Haddad

5th Bristol

2/3/2017

Danielle W. Gregoire

4th Middlesex

1/25/2017

Christine P. Barber

34th Middlesex

1/23/2017

Daniel Cahill

10th Essex

1/30/2017

Steven Ultrino

33rd Middlesex

1/25/2017

Chris Walsh

6th Middlesex

1/20/2017

Jack Lewis

7th Middlesex

 

Sarah K. Peake

4th Barnstable

 

Diana DiZoglio

14th Essex

 

Michael J. Barrett

Third Middlesex

 

Denise Provost

27th Middlesex

 

Jay R. Kaufman

15th Middlesex

 

Jason M. Lewis

Fifth Middlesex

 

Cory Atkins

14th Middlesex

 

Jennifer E. Benson

37th Middlesex

 

Kenneth I. Gordon

21st Middlesex

 

Ann-Margaret Ferrante

5th Essex

 

John W. Scibak

2nd Hampshire

 

Barbara A. L'Italien

Second Essex and Middlesex

 

Lori A. Ehrlich

8th Essex

 

Carolyn C. Dykema

8th Middlesex

 

Tricia Farley-Bouvier

3rd Berkshire

 

Smitty Pignatelli

4th Berkshire

 

Frank I. Smizik

15th Norfolk

 

John J. Lawn, Jr.

10th Middlesex

 

David Paul Linsky

5th Middlesex

 

Daniel M. Donahue

16th Worcester

 

Brendan P. Crighton

Third Essex

 

Michael S. Day

31st Middlesex

 

Kevin G. Honan

17th Suffolk

 

Carmine L. Gentile

13th Middlesex

 

Ruth B. Balser

12th Middlesex

 

Claire D. Cronin

11th Plymouth

 

Paul McMurtry

11th Norfolk

 

Kay Khan

11th Middlesex

 

William M. Straus

10th Bristol

 

Marjorie C. Decker

25th Middlesex

 

Paul Tucker

7th Essex

 

Louis L. Kafka

8th Norfolk

 

Jonathan Hecht

29th Middlesex

 

Thomas M. Stanley

9th Middlesex

 

Natalie Higgins

4th Worcester

 

Mike Connolly

26th Middlesex

 

Dylan Fernandes

Barnstable, Dukes and Nantucket

 

José F. Tosado

9th Hampden

 

Elizabeth A. Malia

11th Suffolk

 

Patrick M. O'Connor

Plymouth and Norfolk

 

Juana B. Matias

16th Essex

 

Michelle M. DuBois

10th Plymouth

 

Josh S. Cutler

6th Plymouth

 

Paul R. Heroux

2nd Bristol

 

William C. Galvin

6th Norfolk

 

Jennifer L. Flanagan

Worcester and Middlesex

 

James M. Cantwell

4th Plymouth

 

Mathew Muratore

1st Plymouth

 

Solomon Goldstein-Rose

3rd Hampshire

 

Theodore C. Speliotis

13th Essex

 

Gailanne M. Cariddi

1st Berkshire

 

Jay D. Livingstone

8th Suffolk

 

Paul Brodeur

32nd Middlesex

 

Daniel J. Ryan

2nd Suffolk

 

Daniel Cullinane

12th Suffolk

 

Edward F. Coppinger

10th Suffolk

 

Mary S. Keefe

15th Worcester

 

Adrian Madaro

1st Suffolk

 

Sean Garballey

23rd Middlesex

 

Gerard Cassidy

9th Plymouth

 

Harold P. Naughton, Jr.

12th Worcester

 

Denise C. Garlick

13th Norfolk

 

Stephen Kulik

1st Franklin

 

Bud Williams

11th Hampden

 

Stephan Hay

3rd Worcester

 

James J. O'Day

14th Worcester

 

Aaron Michlewitz

3rd Suffolk

 

John J. Mahoney

13th Worcester

 

Michael O. Moore

Second Worcester

 

David M. Rogers

24th Middlesex

 

Joan B.  Lovely

Second Essex

 

Byron Rushing

9th Suffolk

 

James B. Eldridge

Middlesex and Worcester

 

Aaron Vega

5th Hampden

 

Alice Hanlon Peisch

14th Norfolk

 

Joan Meschino

3rd Plymouth

 

Leonard Mirra

2nd Essex

 

Linda Dorcena Forry

First Suffolk

 

William Driscoll

7th Norfolk

 

Carole A. Fiola

6th Bristol

 


HOUSE DOCKET, NO. 3059        FILED ON: 1/20/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2960

By Ms. Hogan of Stow, a petition (accompanied by bill, House, No. 2960) of Kate Hogan and others relative to common summary of payments forms for health care services.  Financial Services.

 

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 871 OF 2015-2016.]

 

The Commonwealth of Massachusetts

 

_______________

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

_______________

 

An Act to protect access to confidential healthcare.

 

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 176O of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out section 27 and inserting in place thereof the following  section:-

Section 27. (a) The division shall develop a common summary of payments form to be used by all carriers in the commonwealth and provided to health care consumers with respect to provider claims submitted to a payer. The common summary of payments form shall be written in an easily readable and understandable format showing the consumer’s responsibility, if any, for payment of any portion of a health care provider claim; provided, however, that the division shall allow the development and use of forms that may be exchanged securely through electronic  means; and, provided further, that carriers shall not be obligated to issue a summary of payments form for provider claims that consist solely of requests for co-payment.

(b) Carriers shall issue common summary of payments forms at the member level for each insured member. Carriers may establish a standard method of delivery of summary of payments forms. All carriers shall permit any (i) subscriber who is legally authorized to consent to care for the insured member, (ii) insured member who is legally authorized to consent to her or his own care, or (iii) other party who has the exclusive legal authorization to consent to care for the insured member to choose in writing an alternative method of receiving the common summary of payments form, which shall include, but not be limited to, the following: (A) sending a paper form to the address of the subscriber; (B) sending a paper form to the address of the insured member; (C) sending a paper form to any alternate address upon request of the insured member; or (D) allowing the subscriber, the insured member, or both to access the form through electronic means, provided, however that such access is provided in compliance with any applicable state and federal laws and regulations pertaining to data privacy and security, including, but not limited to, 45 CFR part 160, subparts A and C of 45 CFR part 164, chapters 93H and 93I of the General Laws, and 201 C.M.R. 17.00, as may be amended.

(c) All carriers shall also permit another party legally authorized to consent to care for an insured member to request and must accommodate a reasonable request by such third party to receive the forms on behalf of the member in any of the alternative methods listed pursuant to subsection (b), provided that the third party clearly states in writing that the disclosure of all or part of the information could endanger the party or the insured member.  Upon receipt of such a request, carriers shall not inquire as to the reasons for, or otherwise seek to confirm, the endangerment.

(d) The preferred method of receipt shall be valid until the insured member submits a request in writing for a different method; provided that a carrier shall not be required to maintain more than one alternate address for a member. Carriers shall comply with an insured member’s request pursuant to this subsection within 3 business days of receipt of the request.

(e) Carriers shall not describe or specify sensitive health care services in a common summary of payments form. The division shall define sensitive health care services for purposes of this section. In determining the definition the division shall consider the recommendations of the National Committee on Vital and Health Statistics and similar regulations in other states, and shall consult with experts in fields including, but not limited to, infectious disease, reproductive and sexual health, domestic violence and sexual assault, and mental health and substance use disorders.

(f) In the event that the insured member has no liability for payment for any procedure or service, carriers shall permit all insured members who are legally authorized to consent to  care, or parties legally authorized to consent to care for the insured member, to request suppression of summary of payments forms for a specific service or procedure, in which case summary of payments forms shall not be issued; provided, however, that the insured member clearly makes the request orally or in writing. The carrier may request verification of the request in writing following an oral request. Carriers shall not require an explanation as to the basis for an insured member’s request to suppress summary of payments forms, unless otherwise required by law or court order.

(g) The insured member’s ability to request the preferred method of receipt pursuant to subsection (b) and to request suppression of summary of payments forms pursuant to subsection (f) shall be communicated in plain language and in a clear and conspicuous manner in evidence of coverage documents, member privacy communications and on every summary of payments form and shall be conspicuously displayed on the carrier’s member website and online portals for individual members.

(h) The division shall promulgate regulations necessary to implement and enforce this section, which shall include requirements for reasonable reporting by carriers to the division regarding compliance and the number and type of complaints received regarding noncompliance with this section.

(i) The division, in collaboration with the department of public health, shall develop and implement a plan to educate providers and consumers regarding the rights of insured members and the responsibilities of carriers to promote compliance with this section. The plan shall include, but not be limited to, staff training and other education for hospitals, community health centers, school-based health centers, physicians, nurses and other licensed health care professionals, as well as administrative staff, including but not limited to all staff involved in patient registration and confidentiality education and billing staff involved in processing insurance claims. The plan shall be developed in consultation with groups representing health care insurers, providers, and consumers, including consumer organizations concerned with the provision of sensitive health services.

SECTION 2. The regulations required pursuant to subsection (h) of section 27 of chapter 176O of the General Laws shall take effect no later than 3 months after the effective date of this act.

SECTION 3. Subsection (i) of section 27 of chapter 176O of the General Laws shall take effect 6 months after the effective date of this act.

SECTION 4. Subsections (b) to (g), inclusive of section 27 of chapter 176O of the General Laws shall take effect 12 months after the effective date of this act.

SECTION 5. Clause (D) of subsection (b) of chapter 176O of the General Laws shall take effect 24 months after the effective date of this act; provided, however, that any carrier that has the capacity to provide electronic access to summary of payments forms prior to that date shall do so.