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HOUSE DOCKET, NO. 2754        FILED ON: 1/21/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2065

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Louis L. Kafka

_________________

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 the treatment of cleft palate and cleft lip.

_______________

PETITION OF:

 

Name:

District/Address:

Louis L. Kafka

8th Norfolk

John W. Scibak

2nd Hampshire

Jennifer E. Benson

37th Middlesex

George T. Ross

2nd Bristol

Theodore C. Speliotis

13th Essex

Peter V. Kocot

1st Hampshire

Cory Atkins

14th Middlesex

Anne M. Gobi

5th Worcester

Stephen R. Canessa

12th Bristol

David Paul Linsky

5th Middlesex

Timothy R. Madden

Barnstable, Dukes and Nantucket

James Arciero

2nd Middlesex

Geraldine M. Creedon

11th Plymouth

Kimberly N. Ferguson

1st Worcester

Thomas M. Stanley

9th Middlesex

Denise Provost

27th Middlesex

Christine E. Canavan

10th Plymouth

Garrett J. Bradley

3rd Plymouth

Kathi-Anne Reinstein

16th Suffolk

James M. Cantwell

4th Plymouth

David M. Torrisi

14th Essex

Eileen M. Donoghue

 

Denise Andrews

2nd Franklin

James B. Eldridge

 

William C. Galvin

6th Norfolk

Jonathan Hecht

29th Middlesex

James E. Timilty

 


HOUSE DOCKET, NO. 2754        FILED ON: 1/21/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2065

By Mr. Kafka of Stoughton, a petition (accompanied by bill, House, No. 2065) of Louis L. Kafka and others relative to health insurance policies requirements to provide coverage for the treatment of children with cleft lips and palates.  Financial Services. 

 

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 932 OF 2009-2010.]

 

The Commonwealth of Massachusetts

 

_______________

In the Year Two Thousand Eleven

_______________

 

An Act relative to the treatment of cleft palate and cleft lip.

 

              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, as appearing in the 2006 Official Edition, is hereby amended by adding the following section:

              Section  17J.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 2.  Chapter 118E, is hereby amended by adding the following section:

              Section  61.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 3.  Section 108 of Chapter 175 is hereby amended by adding the following section:

              Section  K.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 4.  Section 110 of Chapter 175 is hereby amended by adding the following section:

              Section  N.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 5.  Chapter 176A of the General Laws is hereby amended by adding the following section:

              Section  8CC.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 6.  Chapter 176B of the General Laws is hereby amended by adding the following section:

              Section  4CC.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 7.  Chapter 176G of the General Laws is hereby amended by adding the following section:

              Section  4U.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

              SECTION 8.  Chapter 176I of the General Laws is hereby amended by adding the following section:

              Section  12.  Notwithstanding any general or special law or rule or regulation to the contrary, a health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child.  The coverage must include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to insure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits.  Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision. 

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