HOUSE DOCKET, NO. 1698        FILED ON: 1/18/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1125

The Commonwealth of Massachusetts

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PRESENTED BY:

David Allen Robertson

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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 to increase enrollment in affordable health plan networks.

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PETITION OF:

HOUSE DOCKET, NO. 1698        FILED ON: 1/18/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1125

The Commonwealth of Massachusetts

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

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An Act to increase enrollment in affordable health plan networks.

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. Subsection (a) of section 11 of Chapter 176J of the General Laws is hereby amended by inserting at the end thereof the following:-

The commissioner may also exempt carriers from complying with this section based on (i) whether the majority of a carrier’s chapter 176J membership is enrolled in a single rate region; or (ii) whether the majority of the carrier’s chapter 176J membership is enrolled in subsidized coverage offered under chapter 176Q through which such members receive state or federal subsidies; or (iii) whether the carrier receives 80 per cent or more of its income from government programs, including subsidized coverage offered under chapter 176Q through which such members receive state or federal subsidies.

SECTION 2. Section 9A of Chapter 176O of the Massachusetts General Laws is amended by striking subsection (a) and replacing it with the following:-

"(a)(i) limits the ability of the carrier to introduce or modify a select network plan or tiered network plan by granting the health care provider a guaranteed right of participation; (ii) requires the carrier to place all members of a provider group, whether local practice groups or facilities, in the same tier of a tiered network plan; or (iii) requires the carrier to include all members of a provider group, whether local practice groups or facilities, in a select network plan on an all-or-nothing basis; or"