An Act relative to direct primary care
This bill prohibits health insurance carriers from denying payment for covered services solely because a patient was referred by a provider outside the carrier's network. It directly affects insurance companies (carriers) and their enrollees (patients), ensuring referrals from out-of-network doctors don't lead to denied claims. The key provision appears repeatedly across multiple chapters of health insurance law, mandating that payment decisions cannot be based on the referral source alone. The bill does not change coverage for specific treatments or alter prescription rules, focusing solely on referral-based payment denials. It applies to all health plans governed by the referenced statutes.
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1 primary · 3 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Tom Walsh
DDemocratic
Co
Adam Scanlon
DDemocratic
Co
Jim Hawkins
DDemocratic
Co
Lindsay Sabadosa
DDemocratic
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