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The 193rd General Court of the Commonwealth of Massachusetts

AN ACT RELATIVE TO MANAGED CARE CONTRACTS WITH HOME HEALTH AGENCIES.

Whereas , The deferred operation of this act would tend to defeat its purpose, which is to regulate forthwith certain health contracts, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public convenience.


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. Subdivision 11 of section 108 of chapter 175 of the General Laws, as appearing in the 2002 Official Edition, is hereby amended by adding the following sentence:- In contracting with a provider of home health services or a licensed hospice agency, an insurer shall not require the provider or agency to be accredited by the Joint Commission on Accreditation of Healthcare Organizations or other national accrediting body if the provider is certified for participation in the Medicare program, Title XVIII of the federal Social Security Act, 42 U.S.C. Sections 1395 et seq.

SECTION 2. Subdivision (M) of section 110 of said chapter 175, as so appearing, is hereby amended by adding the following sentence:- In contracting with a provider of home health services or a licensed hospice agency, an insurer shall not require the provider or agency to be accredited by the Joint Commission on Accreditation of Healthcare Organizations or other national accrediting body if the provider is certified for participation in the Medicare program, Title XVIII of the federal Social Security Act, 42 U.S.C. Sections 1395 et seq.

SECTION 3. The fourth paragraph of section 5 of chapter 176A of the General Laws, as so appearing, is hereby amended by adding the following sentence:- A contract between a hospital service corporation and a provider of home health services or licensed hospice agency shall not require the participating home health provider or participating licensed hospice agency to be accredited by the Joint Commission on Accreditation of Healthcare Organizations or other national accrediting body if the agency is certified for participation in the Medicare program, Title XVIII of the federal Social Security Act, 42 U.S.C. Sections 1395 et seq.

SECTION 4. The first paragraph of section 4 of chapter 176B of the General Laws, as so appearing, is hereby amended by adding the following sentence:- A contract between a medical service corporation and a provider of home health services or a licensed hospice agency shall not require the participating home health provider or participating licensed hospice agency to be accredited by the Joint Commission on Accreditation of Healthcare Organizations or other national accrediting body if the agency is certified for participation in the Medicare program, Title XVIII of the federal Social Security Act, 42 U.S.C. Sections 1395 et seq.

SECTION 5. The second paragraph of section 6 of chapter 176G of the General Laws, as so appearing, is hereby amended by adding the following sentence:- No contract between a participating home health agency or a participating licensed hospice agency and a health maintenance organization shall be issued or delivered in the commonwealth that requires the participating home health agency or participating licensed hospice agency to be accredited by the Joint Commission on Accreditation of Healthcare Organizations or other national accrediting body if it is certified for participation in the Medicare program, Title XVIII of the federal Social Security Act, 42 U.S.C. Sections 1395 et seq.

SECTION 6. The first paragraph of section 2 of chapter 176I of the General Laws, as so appearing, is hereby amended by adding the following sentence:- A preferred provider arrangement entered into between an organization and a home health agency or licensed hospice agency shall not require the participating home health agency or participating licensed hospice agency to be accredited by the Joint Commission on Accreditation of Healthcare Organizations or other national accrediting body if the agency is certified for participation in the Medicare program, Title XVIII of the federal Social Security Act, 42 U.S.C. Sections 1395 et seq.

SECTION 7. This act shall apply to all contracts involving providers of home health services or licensed hospice agencies that are subject to sections 108 or 110 of chapter 175, section 5 of chapter 176A, section 4 of section 176B, section 6 of chapter 176G or section 2 of chapter 176I of the General Laws and that are entered into, renewed, or amended on or after the effective date of this act.

Approved December 16, 2004.