Amendment ID: S2202-15

Amendment 15

Health Care Coverage for Emergency Psychiatric Services

Ms. Friedman and Mr. Cyr move to amend the bill , in section 43, by inserting after section 30, in lines 734-745, the following section:

Section 31. 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 medically necessary emergency service programs, as defined in section 1 of chapter 175.

And further, by adding the following sections:

SECTION XX. Section 1 of chapter 175, as appearing in the 2016 Official Edition, is hereby amended by inserting after the definition of “Domestic company”, in lines 14 and 15, the following words:-

“Emergency services programs”, all programs subject to contract between the mass behavioral health partnership and nonprofit organizations for the provision of said emergency services.

SECTION XX. Said chapter 175 is hereby further amended by adding the following section:-

Section 47JJ. 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 medically necessary emergency service programs, as defined in section 1 of chapter 175.

SECTION XX. Chapter 176A of the General Laws is hereby amended by adding the following section:-

Section 8LL. 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 medically necessary emergency service programs, as defined in section 1 of chapter 175.

SECTION XX. Chapter 176B of the General Laws is hereby amended adding the following section:-

Section 4LL. 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 medically necessary emergency service programs, as defined in section 1 of chapter 175.

SECTION XX. Chapter 176G of the General Laws is hereby amended by adding the following section:-

Section 4DD. A health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for medically necessary emergency service programs, as defined in section 1 of chapter 175.

SECTION XX. All policies, contracts and certificates of health insurance subject to section 31 of chapter 32A, section 47JJ of chapter 175, section 8LL of chapter 176A, section 4LL of chapter 176B, and section 4DD of chapter 176G of the General Laws, which are delivered, issued or renewed on or after January 1, 2015 shall conform with the provisions of this act. Form filings implementing this act shall be subject to the approval of the commissioner of insurance.

SECTION XX. This act shall take effect on January 1, 2018.