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HOUSE DOCKET, NO. 812         FILED ON: 1/15/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1058

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Ellen Story and John Hart, Jr.

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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 relative to continuity of care for families enrolled in MassHealth.

_______________

PETITION OF:

 

Name:

District/Address:

Ellen Story

3rd Hampshire

John Hart, Jr.

First Suffolk

Kay Khan

11th Middlesex

Timothy J. Toomey, Jr.

26th Middlesex

Ruth B. Balser

12th Middlesex

Denise Provost

27th Middlesex

Gailanne M. Cariddi

1st Berkshire

Tricia Farley-Bouvier

3rd Berkshire

Michael D. Brady

9th Plymouth

Patricia D. Jehlen

Second Middlesex

Jason Lewis

 

Sal N. DiDomenico

Middlesex and Suffolk

Benjamin Swan

11th Hampden

Jonathan Hecht

29th Middlesex

Denise Andrews

2nd Franklin

Elizabeth A. Malia

11th Suffolk

Thomas M. Stanley

9th Middlesex

Carl M. Sciortino, Jr.

34th Middlesex


HOUSE DOCKET, NO. 812        FILED ON: 1/15/2013

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1058

By Ms. Story of Amherst and Senator Hart, a joint petition (accompanied by bill, House, No. 1058) of Ellen Story and others relative to continuity of care for families enrolled in MassHealth.  Health Care Financing. 


The Commonwealth of Massachusetts
 

_______________

In the Year Two Thousand Thirteen

_______________

 

An Act relative to continuity of care for families enrolled in MassHealth.
 

              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 118E of the General Laws is hereby amended by inserting after section 9F the following new section:-

              Section 9G. Primary Care Assignments

              (a)  In the case of a MassHealth member under the age of 18 who is re-enrolled in MassHealth after a lapse in MassHealth coverage of less than 18-months duration, the office of medicaid shall make every effort to assign the child to the same primary care provider that either, in order of priority:

              (1)  The family had designated as the primary care provider of choice for the child; or

              (2)  The child had been assigned by MassHealth previously.

              In all cases a more recent, active choice by the family of another primary care provider for the child shall take priority over any of the above.

              (b)  In the case of a newborn child enrolled in MassHealth who is born to, or adopted by a custodial parent with other children who are enrolled in MassHealth, the office of medicaid shall make every effort to assign the newborn child to the same primary care provider that sees the older children.  In the event that the child’s older siblings are assigned to different primary care providers, the office of medicaid shall assign the child to the same primary care provider as the next youngest child.  In all cases, the custodial parents' active choice of a different primary care provider shall be honored.

              (c)  Primary care assignments not meeting the criteria of subsections (a) and (b) above shall not prevent a child from seeing the provider to which they should have been assigned had this criteria been followed by MassHealth, and shall not prevent a primary care provider from being reimbursed for any visit that would have been reimbursed had the requirements of this section been met.

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