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April 14, 2024 Clouds | 44°F
The 193rd General Court of the Commonwealth of Massachusetts

Section 8VV: Coverage for federally-defined preventive services

[ Text of section added by 2023, 28, Sec. 58 effective July 1, 2023. See 2023, 28, Sec. 115.]

  Section 8VV. (a) For the purposes of this section, "federally-defined preventive services'' shall mean: (i) evidence-based items or services that currently have a rating of "A'' or "B'' in the recommendations of the United States Preventive Services Task Force; (ii) immunizations with routine uses in children, adolescents and adults that currently have a recommendation from the Advisory Committee on Immunization Practices of the federal Centers for Disease Control and Prevention with respect to the individual involved; (iii) with respect to infants, children and adolescents, evidence-informed preventive care and screenings provided for in comprehensive guidelines supported by the federal Health Resources and Services Administration; and (iv) with respect to women, such additional preventive care and screenings not described in clause (i) as provided for in comprehensive guidelines supported by the federal Health Resources and Services Administration; provided, however, that "federally-defined preventive services'' shall also include all other preventive services not subject to cost-sharing, as required by established federal regulatory and sub-regulatory guidance issued on or before July 1, 2023.

  (b) Any contract between a subscriber and a corporation subject to this chapter, pursuant to an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall provide coverage for federally-defined preventive services.

  (c) Coverage provided pursuant to this section shall not be subject to any cost-sharing, including, but not limited to, co-payments, co-insurance or any deductible, as required by established federal regulatory and sub-regulatory guidance issued on or before July 1, 2023.

  (d) Nothing in this section shall prohibit: (i) coverage for items and services in addition to those recommended by the United States Preventive Services Task Force, the Advisory Committee on Immunization Practices of the federal Centers for Disease Control and Prevention or the federal Health Resources and Services Administration; or (ii) denying coverage for items and services that are not recommended by the United States Preventive Services Task Force, the Advisory Committee on Immunization Practices of the federal Centers for Disease Control and Prevention or the federal Health Resources and Services Administration.

  (e) If a recommendation pursuant to subsection (a) is changed during a plan year, a carrier shall not be required to make changes to the health plan during the plan year.