HOUSE DOCKET, NO. 1348        FILED ON: 1/16/2019

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1101

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Lindsay N. Sabadosa and Tami L. Gouveia

_________________

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 assuring prompt access to health care.

_______________

PETITION OF:

 

Name:

District/Address:

Lindsay N. Sabadosa

1st Hampshire

Tami L. Gouveia

14th Middlesex

Nika C. Elugardo

15th Suffolk

Carlos González

10th Hampden

Christina A. Minicucci

14th Essex

José F. Tosado

9th Hampden

Bud L. Williams

11th Hampden


HOUSE DOCKET, NO. 1348        FILED ON: 1/16/2019

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1101

By Representatives Sabadosa of Northampton and Gouveia of Acton, a petition (accompanied by bill, House, No. 1101) of Lindsay N. Sabadosa, Tami L. Gouveia and others relative to insurance reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office and hospital-based clinics.  Financial Services.

 

The Commonwealth of Massachusetts

 

_______________

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

_______________

 

An Act assuring prompt access to health 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. Chapter 32A of the General Laws is hereby amended by adding at the end the following new section:

Section 28:  Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.

SECTION 2. Chapter 32B of the General Laws is hereby amended by adding at the end the following new section:

Section 30:  Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.

SECTION 3.  Chapter 175 of the General Laws is hereby amended by inserting the following section:-

Section 47LL: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.

SECTION 4.  Chapter 176A of the General Laws is hereby amended by inserting the following section:- 

Section 8NN: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.

SECTION 5.  Chapter 176B of the General Laws is hereby amended by inserting the following section:-

Section  4NN: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that a deductible shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.

SECTION 6.  Chapter 176G of the General Laws is hereby amended by inserting the following new section 33:- 

Section  33: Reimbursement of costs for medically appropriate evaluation and management services in outpatient settings, including but not limited to office- and hospital-based clinics, in accordance with guidelines developed by the division of insurance, shall be part of a basic benefits package offered by the insurer or a third party and shall not require a deductible; provided, however, that a deductible shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles for these services.