Skip to Content


HOUSE DOCKET, NO. 1115         FILED ON: 1/16/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1920

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Michael A. Costello

_______________

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 transparent billing practices.

_______________

PETITION OF:

 

Name:

District/Address:

Michael A. Costello

1st Essex


HOUSE DOCKET, NO. 1115        FILED ON: 1/16/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1920

By Mr. Costello of Newburyport, a petition (accompanied by bill, House, No. 1920) of Michael A. Costello relative to requiring that health care facilities, ambulatory surgical centers, or outpatient facilities bill all public and private payers for services using their assigned national provider identification number.  Public Health. 

 

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 1471 OF 2011-2012.]


The Commonwealth of Massachusetts
 

_______________

In the Year Two Thousand Thirteen

_______________

 

An Act relative to transparent billing practices.
 

              Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

              Chapter 111 is hereby amended by inserting the following new section: Section 51 ½. Hospital Billing and Licensure. As used in this section the following terms shall have the following meanings: “Facility of Primary Licensure” means the single physical structure and location where the majority of the hospital’s licensed beds are located. (a) Every acute-care hospital that provides any services at a location other than its “Facility of Primary Licensure” is prohibited from operating a Secondary Facility pursuant to the original license of the Facility of Primary Licensure and is hereby required to obtain from the Department a new license for that location if the facility constitutes a Secondary Facility. A facility constitutes a Secondary Facility if: a. The facility is physically located a distance greater than 500 yards, or b. The facility requires or maintains separate heating, cooling, electric, sewer systems from the Facility of Primary Licensure. (b) The licensed Secondary Facility shall obtain from the federal Centers for Medicare and Medicaid Services a separate National Provider Identification Number. (c) Every health care facility, ambulatory surgical center, or outpatient facility shall bill all public and private payors for services using the National Provider Identification Number assigned to the specific facility and physical locations where the services were provided. (d) No public or private payor shall be required to pay a claim billed by a health care facility, ambulatory surgical center, or outpatient facility not billed in accordance with this section. (e) Subject to any agreement between the parties, a Secondary facility shall bill a carrier for services at a rate negotiated by the parties separately from the rates for the Facility of Primary Licensure or in the absence of an agreement, 110% of Medicare. (f) Notwithstanding the provisions of this chapter the Department shall not grant a license to any Secondary Facility unless there is a determination by the department that there is a need for such a facility pursuant to Section 25C. Secondary Facilities in operation as of the effective date of this section shall be exempt from the Department’s determination of need requirements. (g) The Department along with the Office of the Attorney General shall have the authority to enforce the requirements of this section.

The information contained in this website is for general information purposes only. The General Court provides this information as a public service and while we endeavor to keep the data accurate and current to the best of our ability, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk.

Error