Amendment #4 to H4773

An Act increasing access to postpartum home visiting services

Mr. Worrell of Boston moves to amend the bill by adding the following section:

“SECTION XXXX. Chapter 32A of the General Laws, is hereby amended by inserting after section 30 the following section:-

Section 31. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the universal postpartum home visiting program administered by the department of public health. Such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any deductible.

SECTION XXXX. Chapter 111 is hereby amended by adding after Section 243 the following section:-

Section 244. (a) For the purposes of this section, the following words shall have the following meanings:-

“Department”, the department of public health.

“Provider”, an entity or individual that provides universal postpartum home visiting services.

“Programs”, entities or providers qualified by the department of public health to provide universal postpartum home visiting services.

“Universal postpartum home visiting services”, evidence-based, voluntary home or community-based services for birthing people and caregivers with newborns, regardless of age, income, number of children, or other criteria. Services shall be delivered by a qualified health professional with maternal and child health training, as defined by the department of public health, during at least one visit in the family’s home or a mutually agreed upon location within eight weeks postpartum, and one follow-up visit no later than three months after the first visit. Services shall include, but not be limited to, screenings for unmet health needs including reproductive health services, maternal and infant nutritional needs, substance use, emotional health including postpartum depression personal safety/domestic violence; clinical assessment of the birthing person and infant; brief intervention; education and support; referrals to community resources, such as breastfeeding supports; and follow up phone calls.

(b) The department shall establish and administer a statewide system of programs providing universal postpartum home visiting services. The department shall be the lead agency for the coordination of all government funding, both state and federal, for such programs. The department may contract with agencies, individuals or groups for the provision of such services, subject to appropriation. The department shall begin implementation of the universal newborn nurse home visiting program first in those communities with the greatest inequities in maternal health outcomes, as identified by the department. The department shall scale up the program to achieve universal, statewide access within six years of the passage of this act.

(c) In designing the program designed in subsection (b) of this section, the department shall consult, coordinate, and collaborate, as necessary, with insurers that offer health benefit plans in the commonwealth, MassHealth officials, hospitals, local public health departments, birthing centers, existing early childhood home visiting programs, community-based organizations, and social service providers.

(d) A provider of universal postpartum home visiting services shall determine whether any recipient for whom it provides said services are or may be eligible for coverage of said services through an alternative source. The department is the payer of last resort, and a provider shall request payment for services it provides from third-party payers pursuant to chapters 32A, 118E, 175, 176A, 176B, or 176G of the General Laws, before payment is requested from the department.

(e) The department shall collect and analyze data generated by the program to monitor and assess the effectiveness of universal postpartum home visiting services. The department shall work with other state agencies to develop protocols for sharing data, including the timely sharing of data with primary care providers of care to the families with newborns receiving the services. Programs which are in receipt of state or federal funding for said services shall report such information as requested by the department for the purpose of monitoring, assessing the effectiveness of such programs, initiating quality improvement, and reducing health disparities.

SECTION XXXX. Chapter 118E of the General Laws, is hereby amended by inserting after section 10N the following section:-

Section 10O. The division and its contracted managed care organizations, accountable care organizations, health plans, integrated care organizations, third-party administrators, or other entities contracting with the division to administer benefits, shall provide coverage for universal postpartum home visiting services, in accordance with operational standards set by the department of public health pursuant to section 244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing.

SECTION XXXX. Chapter 175 of the General Laws, is hereby amended by inserting after section 47PP the following section:-

Section 47QQ. An individual policy of accident and sickness insurance issued pursuant to section 108 that provides hospital expense and surgical expense insurance or a group blanket or general policy of accident and sickness insurance issued pursuant to section 110 that provides hospital expense and surgical expense insurance that is issued or renewed within the commonwealth shall provide coverage for universal postpartum home visiting services, in accordance with operational standards set by the department of public health pursuant to section 244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any deductible; provided, however, that co-payments, coinsurance or deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on co-payments, coinsurance or deductibles for these services.

SECTION XXXX. Chapter 176A of the General Laws, is hereby amended by inserting after section 8KK the following section:-

Section 8LL. 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 universal postpartum home visiting services, in accordance with operational standards set by the department of public health pursuant to section 244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any deductible; provided, however, that co-payments, coinsurance or deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on co-payments, coinsurance or deductibles for these services.

SECTION XXXX. Chapter 176B of the General Laws, is hereby amended by inserting after section 4KK the following section:-

Section 4LL. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for universal postpartum home visiting services, in accordance with operational standards set by the department of public health pursuant to section 244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any deductible;

provided, however, that co-payments, coinsurance or deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on co-payments, coinsurance or deductibles for these services.

SECTION XXXX. Chapter 176G of the General Laws, is hereby amended by inserting after section 4KK the following section:-

Section 4LL. Any individual or group health maintenance contract that is issued or renewed within the commonwealth shall provide coverage for universal postpartum home visiting services, in accordance with operational standards set by the department of public health pursuant to section 244 of chapter 111 of the General Laws. Such coverage shall not be subject to any cost-sharing, including co-payments and co-insurance, and shall not be subject to any deductible; provided, however, that co-payments, coinsurance or deductibles shall be required if the applicable plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on co-payments, coinsurance or deductibles for these services.

Additional co-sponsor(s) added to Amendment #4 to H4773

An Act increasing access to postpartum home visiting services