Maddy summaryThis bill ensures that individuals in Massachusetts can continue seeing their mental health providers even if those providers are removed from an insurance network or the insurance company changes. It defines a "continuing course of treatment" as having at least one visit in the past four months for the same condition or similar symptoms. Under the new rules, insurance carriers must pay the full in-network rate to providers who are out-of-network due to disenrollment or plan changes, unless the removal was due to fraud or quality issues. Patients may face a higher co-payment only if the carrier proves that using an out-of-network provider significantly increases costs, and no new deductibles or additional charges are allowed for this coverage.
Rep. Rodney Elliott
Sponsored bills
Maddy summaryThis bill aims to increase access to dental care for MassHealth enrollees by offering financial incentives to participating dentists and public health dental hygienists. Under the new provisions, eligible providers located in specific municipalities with high numbers of MassHealth members and low dental service usage will receive an additional payment of $31 for each patient encounter. To qualify for these supplemental payments, providers must be licensed in Massachusetts, enrolled with MassHealth, and located in areas designated by the Secretary of Health and Human Services as having significant unmet dental needs. The legislation requires the department to create regulations defining which municipalities are eligible based on historical enrollment and utilization data.
Maddy summaryThis bill amends Massachusetts state law to prohibit insurance companies from discriminating against hospitals and pharmacies that participate in the federal 340B drug discount program. It specifically forbids insurers from charging these entities lower reimbursement rates, imposing unique fees or audit requirements, or restricting their network participation solely because they dispense discounted drugs. The legislation aims to ensure that 340B-covered entities are treated the same as other pharmacies regarding insurance claims, fees, and contractual terms. By banning these specific practices, the bill seeks to protect the financial stability of safety-net providers that rely on these federal discounts to offer affordable care.
Maddy summaryThis bill requires public employers in Massachusetts to provide full-time firefighter employees with free cancer screenings every three years, starting at least three years after they begin working. The screenings must cover a specific list of cancers including lung, colon, and prostate cancer, and the employer's health plan must pay for all costs without requiring any co-pays or deductibles from the firefighters. The law applies to firefighters working for state agencies, cities, towns, and various military and port authority fire departments.
Maddy summaryThis bill requires that community health centers in Massachusetts be reimbursed using a specific payment method known as a prospective payment system. The law mandates that this reimbursement approach aligns with federal guidelines established in the United States Code as of January 1, 2023. By updating state statutes, the bill ensures that insurers and other payers follow this standardized calculation for services provided by these federally qualified health centers. The change directly affects how these healthcare facilities are paid for patient care and aims to create consistency between state and federal payment rules.
By Representatives Gentile of Sudbury and Kane of Shrewsbury, a petition (accompanied by bill, House, No. 2182) of Carmine Lawrence Gentile, Hannah Kane and others for legislation to reduce incidence and death from pancreatic cancer. Public Health.
Maddy summaryThis bill requires insurance companies in Massachusetts to pay safety net hospitals at least as much as the state's average commercial rate for inpatient and outpatient services. It specifically targets acute care hospitals that treat at least 25% of their patients through Medicaid and serve communities facing health disparities due to race, ethnicity, or socioeconomic status. If an insurer pays these hospitals less than the statewide average, their commercial insurance rates will be automatically rejected by the state insurance commissioner unless they provide proof of higher payments. The law applies to all commercial health plans starting January 1, 2023, aiming to ensure these hospitals receive fair reimbursement to maintain access to care.
Maddy summaryThis bill aims to improve access to telehealth services and address digital inequality for patients in Massachusetts. It requires state agencies to link the application process for affordable internet programs with the portal used to apply for other health benefits, helping those who need reliable internet to use telehealth. Additionally, the bill restricts insurance companies from requiring prior authorization for telehealth visits if they do not require it for in-person appointments and mandates that telehealth coverage includes reimbursement for interpreter services for patients with limited English proficiency or hearing impairments.
By Representative Capano of Lynn, a petition (subject to Joint Rule 12) of Peter Capano that the Secretary of Veterans' Services be authorized to create a veterans' benefits and services notice and that certain employers be required to post said notice. Veterans and Federal Affairs.
Maddy summaryThis bill amends Massachusetts laws to clarify how tow companies can place liens on vehicles. It specifically allows liens to be issued for cars towed from private property or involuntarily transported from accident scenes. The changes update existing statutes to ensure the legal process for collecting unpaid towing fees is clearly defined for private property owners and towing operators.