HOUSE DOCKET, NO. 1364        FILED ON: 1/18/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1022

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Colleen M. Garry

_________________

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 access to care for Ehler Danlos syndrome patients.

_______________

PETITION OF:

HOUSE DOCKET, NO. 1364        FILED ON: 1/18/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1022

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 1095 OF 2021-2022.]

The Commonwealth of Massachusetts

_______________

In the One Hundred and Ninety-Third General Court
(2023-2024)

_______________

An Act relative to access to care for Ehler Danlos syndrome patients.

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 17O, as inserted by chapter 233 of the acts 2016, the following section:-

Section 17P. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission that provides coverage for cancer chemotherapy treatment shall provide coverage for physical therapy preventative, ongoing chronic maintenance, and acute treatment for Ehler Danlos Syndrome patients.

SECTION 2.  Chapter 175 of the General Laws is hereby amended by inserting after section 47II, as inserted by chapter 233 of the acts 2016, the following section:- 

Section 47JJ. Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides medical expense coverage shall provide for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results or response to therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.

SECTION 3.  Chapter 176A of the General Laws is hereby amended by inserting after section 8KK, as inserted by chapter 233 of the acts 2016, the following section:- 

Section 8LL. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall provide coverage for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results or response to therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.

SECTION 4. Chapter 176B of the General Laws is hereby amended by inserting after section 4KK, as inserted by chapter 233 of the acts 2016, the following section:-  

Section 4LL. Any subscription certificate under an individual or group medical service agreement delivered, issued, or renewed within the Commonwealth shall provide coverage for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results and  response in therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.

SECTION 5. Chapter 176G of the General Laws is hereby amended by inserting after section 4CC, as inserted by chapter 233 of the acts 2016, the following section:-  

Section 4DD. Any individual or group health maintenance contract shall provide coverage for preventative, ongoing chronic maintenance and acute treatment physical therapy for Ehler Danlos Syndrome patients when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results and  response in therapy. Therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such therapy may be characterized as unproven, experimental, or investigational in nature.