Budget Amendment ID: FY2017-S4-549-R1

Redraft EHS 549

Safeguarding Consumer Parity Rights

Mr. Joyce moved that the proposed new text be amended by inserting the following new section:-

SECTION XX. Chapter 256 of the Acts of 2008 by is hereby amended by adding at the end thereof the following section:-

SECTION 18. A person or entity may, after exhausting internal appeals with the health insurance provider, bring a civil action in Superior Court for a violation of this chapter G.L. c. 175, §47B; G.L. c. 176A, §8A; G.L. c. 176B, §4A; G.L. c. 176G, §4M; or applicable regulations including, but not limited to, 211 CMR 154. If the court finds for the petitioner, the recovery for such actions shall include, but shall not be limited to, treble damages, court costs, and attorneys’ fees. In addition, the court shall award such other equitable relief as it deems to be necessary and proper.

Any persons entitled to bring such action may, if the violation of parity has caused similar denial of care to numerous other persons similarly situated and if the court finds in a preliminary hearing that he adequately and fairly represents such other persons, bring the action on behalf of himself and such other similarly injured and situated persons; the court shall require that notice of such action be given to unnamed petitioners in the most effective, practicable manner. Such action shall not be dismissed, settled or compromised without the approval of the court, and notice of any proposed dismissal, settlement or compromise shall be given to all members of the class of petitioners in such a manner as the court directs.

Persons who are covered by health plans through MassHealth, as established in G.L. c.118E, or the Group Insurance Commission, as established under G.L. c.32A and c.32B, may not bring an action under this section.