Amendment 28

Budget Amendment ID: FY2012-S3-28

OTH 28

Special education health care costs

Ms. Creem moved that the proposed new text be amended by inserting, after Section __, the following new Section:-

(a) Chapter 32A of the General Laws is hereby amended by adding the following section:-

Section 26. The commission shall provide to an active or retired employee of the commonwealth who is insured under the group insurance commission benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury, or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

(b) Chapter 175 of the General Laws is hereby amended by inserting after section 47AA the following section:-

Section 47BB. An individual policy of accident and sickness insurance issued under section 108 that provides hospital expense and surgical expense insurance and any group blanket or general policy of accident and sickness insurance issued under section 110 that provides hospital expense and surgical expense insurance, which is issued or renewed within or without the commonwealth, shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury, or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

Section 8EE. A contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury, or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

(d) Chapter 176B of the General Laws is hereby amended by inserting after section 4DD the following section:-

Section 4EE. A subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury, or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

(e) Chapter 176G of the General Laws is hereby amended by inserting after section 4V the following section:-

Section 4W. A health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury, or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

(f) All policies, contracts and certificates of health insurance subject to section 26 of chapter 32A, section 47BB of chapter 175, section 8EE of chapter 176A, section 4EE of chapter 176B, and section 4W of chapter 176G of the General Laws which are delivered, issued or renewed on or after January 1, 2011 shall conform with the provisions of this act. Form filings implementing this act shall be subject to the approval of the commissioner of insurance.

(g) This section shall take effect on January 1, 2012.