Amendment #47 to H4888

Advancing Racial and Socioeconomic Equity in Commercial Health Insurance

Representatives Moran of Lawrence, Minicucci of North Andover, Nguyen of Andover, Campbell of Methuen and Devers of Lawrence move to amend the bill, as amended, by adding the following section: Section XX. (a) Notwithstanding any general or special law to the contrary, given inequitable commercial insurance rates and the negative impact that such inequitable rates have on the delivery of care by high Medicaid safety net hospitals and their affiliated physicians predominantly serving communities that experience health disparities as a result of race, ethnicity, socioeconomic status or other status, the division of insurance shall require through an annual certification process that commercial insurance rates of payment effective January 1, 2021 through insurance companies organized under chapter 175 of the General Laws, hospital service corporations organized under chapter 176A of the General Laws, medical service corporations organized under chapter 176B of the General Laws, health maintenance organizations organized under chapter 176G of the General Laws and preferred provider organizations organized under chapter 176I of the General Laws, insurers participating under chapter 176J of the General Laws, and the group insurance commission under chapter 32A of the General Laws are (i) no less than the carrier's statewide average commercial relative price to acute care hospitals with a fiscal year 2018 Medicaid payer mix at or above 25 per cent; (ii) no less than the separately calculated carrier’s statewide average commercial relative price to their affiliated physicians; and (iii) reflect said rates in (i) and (ii) of this subsection in rebased total medical expense budgets.

(b) If the division determines that a carrier does not meet the certification requirements in subsection (a), the division shall notify the carrier and presumptively disapprove the rates filed by the carrier.

Additional co-sponsor(s) added to Amendment #47 to H4888

Advancing Racial and Socioeconomic Equity in Commercial Health Insurance