Budget Amendment ID: FY2016-S3-846

EHS 846

HIV-Associated Lipodystrophy Treatment

Mr. Montigny and Ms. O'Connor Ives moved that the proposed new text be amended by inserting after section ___, the following new sections:-

"SECTION ___. Chapter 32A of the General Laws, as appearing in the 2012 Official Edition, is hereby amended by inserting after section 17K the following section:-

Section 17L. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV- associated lipodystrophy syndrome, including but not limited to reconstructive surgery, such as suction assisted lipectomy, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the commission.

SECTION ___. Chapter 175 of the General Laws, as so appearing, is hereby amended by inserting after section 47DD the following section:-

Section 47EE. Any policy of accident and sickness insurance as described in section 108 which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and policyholder in the commonwealth; any blanket or general policy of insurance described in subdivision (A), (C) or (D) of section 110 which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth; or any employees’ health and welfare fund which provides hospital expense and surgical expense benefits and which is delivered, issued or renewed to any person or group of persons in the commonwealth, shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by lipodystrophy syndrome, including but not limited to reconstructive surgery, such as suction assisted lipectomy, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer.

SECTION ___. Chapter 176A of the General Laws, as so appearing, is hereby amended by inserting after section 8FF the following section:-

Section 8GG. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV- associated lipodystrophy syndrome, including but not limited to reconstructive surgery, such as suction assisted lipectomy, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer.

SECTION ___. Chapter 176B of the General Laws, as so appearing, is hereby amended by inserting after section 4FF, the following section:-

Section 4GG. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV- associated lipodystrophy syndrome, including but not limited to reconstructive surgery, such as suction assisted lipectomy, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer.

SECTION ___. Chapter 176G of the General Laws, as so appearing, is hereby amended by inserting after section 4X the following section:-

Section 4Y. Any individual or group health maintenance contract shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV- associated lipodystrophy syndrome, including but not limited to reconstructive surgery, such as suction assisted lipectomy, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer.

SECTION ___. Chapter 118E of the General Laws, as so appearing, is hereby amended by inserting after section 10G the following section:-

Section 10H. The division shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV- associated lipodystrophy syndrome, including but not limited to reconstructive surgery, such as suction assisted lipectomy, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the division."