HOUSE DOCKET, NO. 2499        FILED ON: 1/19/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1081

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

John J. Lawn, Jr.

_________________

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 preserving preventative services without cost sharing.

_______________

PETITION OF:

HOUSE DOCKET, NO. 2499        FILED ON: 1/19/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1081

The Commonwealth of Massachusetts

_______________

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

_______________

An Act relative to preserving preventative services without cost sharing.

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 176O of the General Laws is hereby amended by adding the following section:-

Section 30. (a) For a health plan issued on or after January 1, 2025, a carrier, as defined by this chapter or subject to chapters 32A or 176J, shall, at a minimum, provide coverage for: (i) evidence-based items or services that have a rating of A or B in the recommendations of the United States Preventive Services Task Force, with respect to the individual involved; (ii) immunizations for routine use in children, adolescents and adults in accordance with the recommendations and immunization schedules from the Advisory Committee on Immunization Practices and approved by the director of the centers for disease control and prevention, with respect to the individual involved; (iii) evidence-informed preventive care and screenings for infants, children and adolescents, as described in comprehensive guidelines supported by the Health Resources and Services Administration; and (iv) evidence-informed preventive care for women, to the extent not described in clause (i) of this subsection; provided, that such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any deductible.

(b) Nothing in this section shall prohibit a carrier from providing coverage for items and services in addition to those recommended by the United States Preventive Services Task Force, the Advisory Committee on Immunization Practices, and the Health Resources and Services Administration, or denying coverage for items and services that are not recommended.

(c) If a recommendation described in subsection (a) is changed during a health plan year, a carrier is not required to make changes to that health plan during the plan year.

(d) The division shall issue guidance as necessary to implement and enforce this section.

SECTION 2. The division of insurance shall issue guidance under section 30 of subsection (d) of chapter 176O of the General Laws not later than 90 days after the effective date of this act.