HOUSE DOCKET, NO. 3895        FILED ON: 1/18/2019

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1040

The Commonwealth of Massachusetts

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PRESENTED BY:

Adrian C. Madaro

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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 pediatric plans of care.

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PETITION OF:

HOUSE DOCKET, NO. 3895        FILED ON: 1/18/2019

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1040

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-First General Court
(2019-2020)

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An Act relative to pediatric plans of care.

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.  Notwithstanding any general or special law to the contrary, any child who is being treated for a disability by a provider or therapist licensed under Chapter 112 of the general laws and has a plan of care which is filed with the insurer by the provider or therapist during any one calendar year, and such plan calls for treatment which exceeds the maximum allowable annual treatment sessions under the child's insured plan under Chapter 175 of the general laws shall be granted that maximum allowable number of treatments under the plan of care on an annual basis without further authorization from the insurer on a periodic basis. The insurer shall authorize access to all treatments as filed within the plan of care at the beginning of each calendar year. The provider or therapist shall file quarterly reports with the insurer documenting that the treatment is ongoing and that continued treatment is medically necessary.