Bill H.1105

HOUSE DOCKET, NO. 3455 FILED ON: 2/19/2021

HOUSE . . . . . . . . . . . . . . . No. 1105

By Ms. Gouveia of Acton, a petition (accompanied by bill, House, No. 1105) of Tami L. Gouveia relative to insurance coverage for post-COVID syndrome. Financial Services.

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Second General Court
(2021-2022)

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An Act relative to insurance coverage for post-COVID syndrome.

Whereas, The deferred operation of this act would tend to defeat its purpose, which is to establish forthwith insurance coverage for the treatment and management of post-COVID syndrome, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public convenience.

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 inserting after section 17R, as inserted by section 2 of chapter 260 of the acts of 2020, the following section:-

Section 17S. (a) As used in this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:

“Post-COVID syndrome”, enduring and consistent symptoms that arise (1) after an individual has been infected with the SARS-CoV-2 virus and that the health clinician treating the individual has reason to suspect were related to COVID-19 infection; or (2) in an individual that may be related to COVID-19 infection but a diagnosis of COVID-19 infection was not obtained and cannot be identified due to a lack of antibodies.

Symptoms of post-COVID syndrome may include, but are not limited to: fatigue; shortness of breath; cough; joint pain; chest pain; muscle pain; headache, fast or pounding heartbeat; loss of smell or taste; memory, concentration or sleep problems; mood disorder; heart damage; lung damage; organ damage; rash; hair loss; blood clots or blood vessel problem; and indications of dysautonomia.

(b) The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for treatment of post-COVID syndrome.

SECTION 2. Chapter 112 of the General Laws is hereby amended by inserting after section 12A 1/2 the following section:-

Section 12A ¾. In cases of examination or treatment of a person with post-COVID syndrome, a hospital, community health center or clinic shall report information related to the diagnosis and treatment to the commissioner of public health in a manner determined by the commissioner that complies with 42 U.S.C. section 290dd-2, 42 C.F.R. Part 2 and 45 C.F.R. section 164.512. The department of public health may promulgate regulations to enforce this section.

SECTION 3. Chapter 118E of the General Laws is hereby amended by inserting after section 10N, as inserted by section 39 of chapter 260 of the acts of 2020, the following section:-

Section 10O. (a) As used in this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:

Symptoms may include, but are not limited to: fatigue; shortness of breath; cough; joint pain; chest pain; muscle pain; headache, fast or pounding heartbeat; loss of smell or taste; memory, concentration or sleep problems; mood disorders; heart damage; lung damage; organ damage; rash; hair loss; blood clots or blood vessel problem; and indications of dysautonomia.

(b) The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for the treatment of post-COVID syndrome.

SECTION 4. Chapter 175 of the General Laws is hereby amended by inserting after section 47NN, as inserted by section 47 of said chapter 260, the following section:-

Section 47OO. (a) As used in this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:

“Post-COVID syndrome”, enduring and consistent symptoms that arise (1) after an individual has been infected with the SARS-CoV-2 virus and that the health clinician treating the individual has reason to suspect were related to COVID-19 infection; or (2) in an individual that may be related to COVID-19 infection but a diagnosis of COVID-19 was not obtained and cannot be identified due to a lack of antibodies.

(b) Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth shall provide coverage for treatment of post-COVID syndrome.

SECTION 5. Chapter 176A of the General Laws is hereby amended by inserting after section 8OO, as inserted by section 48 of said chapter 260, the following section:-

Section 8PP. (a) As used in this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:

“Post-COVID syndrome”, enduring and consistent symptoms that arise (1) after an individual has been infected with the SARS-CoV-2 virus and that the health clinician treating the individual has reason to suspect were related to COVID-19 infection; or (2) in an individual that may be related to COVID-19 infection but a diagnosis of COVID-19 was not obtained and cannot be identified due to a lack of antibodies.

(b) Any contract between a subscriber and a corporation under an individual or group hospital service plan delivered, issued or renewed within the commonwealth shall provide coverage for treatment of post-COVID syndrome.

SECTION 6. Chapter 176B of the General Laws is hereby amended by inserting after section 4OO, as inserted by section 50 of said chapter 260 the following section:-

Section 4PP. (a) As used in this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:

“Post-COVID syndrome”, enduring and consistent symptoms that arise (1) after an individual has been infected with the SARS-CoV-2 virus and that the health clinician treating the individual has reason to suspect were related to COVID-19 infection; or (2) in an individual that may be related to COVID-19 infection but a diagnosis of COVID-19 was not obtained and cannot be identified due to a lack of antibodies.

(b) Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for treatment of post-COVID syndrome.

SECTION 7. Chapter 176G of the General Laws is hereby amended by inserting after section 4GG, as inserted by section 52 of said chapter 260 the following section:-

Section 4HH. (a) As used in this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:

“Post-COVID syndrome”, enduring and consistent symptoms that arise (1) after an individual has been infected with the SARS-CoV-2 virus and that the health clinician treating the individual has reason to suspect were related to COVID-19 infection; or (2) in an individual that may be related to COVID-19 infection but a diagnosis of COVID-19 was not obtained and cannot be identified due to a lack of antibodies.

(b) Any individual or group health maintenance contract shall provide coverage for treatment of post-COVID syndrome.

Name:	District/Address:	Date Added:
Tami L. Gouveia	14th Middlesex	2/19/2021