An Act providing insurance coverage for Alfi’s syndrome

This bill mandates that health insurance plans in Massachusetts cover the diagnosis and treatment of Alfi's syndrome, a rare genetic condition also known as 9p deletion syndrome. The legislation requires insurers to provide coverage for various services, including genetic testing, medications, and therapies such as speech, occupational, and physical therapy, without imposing specific limits on the number of visits a patient can make. To ensure fairness, the law stipulates that coverage limits for Alfi's syndrome must be equal to or more generous than those for other physical conditions and exempts certain providers from annual or lifetime dollar caps. Additionally, the bill includes a three-year transition period for insurance companies to implement coverage for specific habilitative or rehabilitative care that was not previously covered, provided they can demonstrate that the costs would significantly impact their premiums.