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The 193rd General Court of the Commonwealth of Massachusetts

AN ACT PROVIDING INSURANCE COVERAGE FOR HUMAN LEUKOCYTE ANTIGEN TESTING FOR CERTAIN INDIVIDUALS AND PATIENTS.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:


SECTION 1. Chapter 32A of the General Laws is hereby amended by inserting after s ction 17G, inserted by section 1 of chapter 81 of the acts of 2000, the following section:-

Section 17H. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish bone marrow transplant donor suitability. The coverage shall cover the costs of testing for A, B or DR antigens, or any combination thereof, consistent with guidelines, criteria, rules or regulations established by the department of public health pursuant to section 218 of chapter 111.

SECTION 2. Chapter 111 of the General Laws is hereby amended by adding after section 217, added by section 3 of chapter 141 of the acts of 2000, the following section:-

Section 218. (a) The commissioner, in collaboration with the commissioner of insurance, shall establish guidelines, criteria, and rules or regulations, as may be necessary, to ensure that human leukocyte antigen testing or histocompatibility locus antigen testing conducted for the purposes of section 17H of chapter 32A, section 47V of chapter 175, section 8V of chapter 176A, section 4V of chapter 176B and section 4N of chapter 176G conform to medical eligibility requirements and other test protocols established by the United States food and drug administration, the American Association of Blood Banks, the joint commission on accreditation of health care organizations and the national marrow donor program registry. The eligibility of a health care facility to conduct such tests shall be established by such guidelines, criteria, rules or regulations, which shall further require such a facility to obtain informed consent from test subjects prior to conducting such tests, and at the time of obtaining such consent, to advise a test subject of the opportunity to participate in the national marrow donor program.

(b) The commissioner shall convene an advisory group of medical experts to assist in making recommendations relative to such guidelines, criteria, rules or regulations, which shall include, but need not be limited to, oncologists recommended by the society of clinical oncology, medical researchers with expertise in the field of bone marrow transplantation, specialists in the area of medical ethics, representatives of bone marrow donation programs, a physician selected by the Massachusetts League of Community Health Centers, a physician selected by a hospital and medical service corporation, and a physician selected by the Massachusetts Association of Health Maintenance Organizations.

SECTION 3. Chapter 175 of the General Laws is hereby amended by inserting after section 47U, inserted by section 8 of said chapter 141, the following section:-

Section 47V. Any individual policy of accident and sickness insurance issued pursuant to section 108, and any group blanket policy of accident and sickness insurance issued pursuant to section 110, except policies providing supplemental coverage to Medicare or to other government programs, delivered, issued or renewed by agreement within or without the commonwealth shall provide coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish bone marrow transplant donor suitability. The coverage shall cover the costs of testing for A, B or DR antigens, or any combination thereof, consistent with rules, regulations and criteria established by the department of public health pursuant to section 218 of chapter 111.

SECTION 4. Chapter 176A of the General Laws is hereby amended by inserting after section 8U, inserted by section 14 of said chapter 141, the following section:-

Section 8V. Any contract between a subscriber and the corporation under an individual or group hospital service plan, except contracts providing supplemental coverage to Medicare or to other government programs, delivered, issued or renewed by agreement within or without the commonwealth shall provide, as benefits to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment within the commonwealth, coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish bone marrow transplant donor suitability. The coverage shall cover the costs of testing for A, B or DR antigens, or any combination thereof, consistent with rules, regulations and criteria established by the department of public health pursuant to section 218 of chapter 111.

SECTION 5. Chapter 176B of the General Laws is hereby amended by inserting after section 4U, inserted by section 15 of said chapter 141, the following section:-

Section 4V. Any subscription certificate under an individual or group medical service agreement, except certificates providing supplemental coverage to Medicare or to other government programs, delivered, issued or renewed by agreement within or without the commonwealth shall provide, as a benefit for all individual subscribers or members within the commonwealth and all group members having a principal place of employment within the commonwealth, coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish bone marrow transplant donor suitability. The coverage shall cover the costs of testing for A, B or DR antigens, or any combination thereof, consistent with rules, regulations and criteria established by the department of public health pursuant to section 218 of chapter 111.

SECTION 6. Chapter 176G of the General Laws is hereby amended by inserting after section 4M, as inserted by section 10 of chapter 80 of the acts of 2000, the following section:-

Section 4N. Any group health maintenance contract, except contracts providing supplemental coverage to Medicare or to other government programs, delivered, issued, or renewed by agreement within or without the commonwealth shall provide for all members or enrollees coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish such member's or enrollee's bone marrow transplant donor suitability. The coverage shall cover the costs of testing for A, B or DR antigens, or any combination thereof, consistent with rules, regulations and criteria established by the department of public health pursuant to section 218 of chapter 111.

Approved December 28, 2000.