SENATE DOCKET, NO. 888        FILED ON: 1/19/2017

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 517

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Kenneth J. Donnelly

_________________

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 transparency for mental health parity.

_______________

PETITION OF:

 

Name:

District/Address:

 

Kenneth J. Donnelly

Fourth Middlesex

 

John F. Keenan

Norfolk and Plymouth

 

Kenneth I. Gordon

21st Middlesex

1/27/2017

Barbara A. L'Italien

Second Essex and Middlesex

1/27/2017

Marjorie C. Decker

25th Middlesex

1/30/2017

James J. Dwyer

30th Middlesex

1/31/2017

Ruth B. Balser

12th Middlesex

2/1/2017

Walter F. Timilty

Norfolk, Bristol and Plymouth

2/2/2017

Michael S. Day

31st Middlesex

2/2/2017

Elizabeth A. Malia

11th Suffolk

2/2/2017

Paul R. Heroux

2nd Bristol

2/3/2017

Sal N. DiDomenico

Middlesex and Suffolk

2/3/2017

James B. Eldridge

Middlesex and Worcester

2/3/2017

Chris Walsh

6th Middlesex

2/3/2017

Bruce E. Tarr

First Essex and Middlesex

3/23/2017


SENATE DOCKET, NO. 888        FILED ON: 1/19/2017

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 517

By Mr. Donnelly, a petition (accompanied by bill, Senate, No. 517) of Kenneth J. Donnelly, John F. Keenan, Kenneth I. Gordon, Barbara A. L'Italien and other members of the General Court for legislation relative to transparency for mental health parity.  Financial Services.

 

The Commonwealth of Massachusetts

 

_______________

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

_______________

 

An Act relative to transparency for mental health parity.

 

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 13 of chapter 176O of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after subsection (d) the following subsection:-

(e) for any grievance involving a denial of coverage for mental health services, including behavioral health and substance abuse disorder services, the carrier shall, in addition to all other notices required under this chapter, provide to the insured and to the insured’s authorized representative, if any, a statement certifying and specifically describing the following:

(i) That the denial of coverage by carrier, or the carrier’s utilization review organization or other subcontracted entity, is in compliance with applicable state parity requirements for providing coverage on a nondiscriminatory basis as defined in chapter 80 of the acts of 2000;

(ii) The quantitative and non-quantitative treatment limitations applied during review, and how said limitation criteria comply with state and federal parity regulations, including those codified at 42 U.S. Code § 300gg-26, and regulations implemented pursuant to section 8K of chapter 26 of the general laws; and

(iii) A certification that the carrier’s claim processing and utilization review methods complied with the above parity requirements.