Presented in the House by: Representatives Lindsay N. Sabadosa and Ruth B. Balser.
Presented in the Senate by: Senator Cindy F. Friedman.
An Act ensuring access to full spectrum pregnancy care
SECTION 1. Section 17C of chapter 32A of the General Laws, as most recently amended by section 8 of chapter 127 of the acts of 2022, is hereby amended by striking out the third paragraph and inserting in place thereof the following paragraph:-
Coverage provided under this section shall not be subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; provided, however, that deductibles, coinsurance or copayments shall be required if the applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles, coinsurance or copayments for these services. Coverage offered under this section shall not impose unreasonable restrictions or delays in the coverage.
SECTION 2. Said section 17C of said chapter 32A, as most recently amended by section 8 of chapter 127, is hereby further amended by adding the following sentence:-
The commission shall ensure plan compliance with this section.
SECTION 3. Section 10A of chapter 118E of the General Laws, as most recently amended by section 19 of chapter 127 of the acts of 2022, is hereby amended by adding the following paragraphs:-
Nothing in this section shall be construed to deny or restrict the division’s authority to ensure its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan are in compliance with this chapter.
The division shall ensure plan compliance with this chapter.
SECTION 4. Section 47F of chapter 175 of the General Laws, as most recently amended by section 22 of chapter 127 of the acts of 2022, is hereby amended by striking out the fourth paragraph and inserting in place thereof the following paragraph:-
Coverage provided under this section shall not be subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; provided, however, that deductibles, coinsurance or copayments shall be required if the applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles, coinsurance or copayments for these services. Coverage offered under this section shall not impose unreasonable restrictions or delays in the coverage.
SECTION 5. Said section 47F of said chapter 175, as recently amended by section 22 of chapter 127 of the acts of 2022, is hereby further amended by adding the following sentence:-
The commissioner shall ensure plan compliance with this section.
SECTION 6. Section 8H of chapter 176A of the General Laws, as most recently amended by section 26 of chapter 127 of the acts of 2022, is hereby amended by striking out the fourth paragraph and inserting in place thereof the following paragraph:-
Coverage provided under this section shall not be subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; provided, however, that deductibles, coinsurance or copayments shall be required if the applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles, coinsurance or copayments for these services. Coverage offered under this section shall not impose unreasonable restrictions or delays in the coverage.
SECTION 7. Said section 8H of said chapter 176A, as most recently amended by section 26 of chapter 127 of the acts of 2022, is hereby further amended by adding the following sentence:-
The commissioner shall ensure plan compliance with this section.
SECTION 8. Section 4H of chapter 176B of the General Laws, as most recently amended by section 29 of chapter 127 of the acts of 2022, is hereby amended by striking out the fourth paragraph and inserting in place thereof the following paragraph:-
Coverage provided under this section shall not be subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; provided, however, that deductibles, coinsurance or copayments shall be required if the applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles, coinsurance or copayments for these services. Coverage offered under this section shall not impose unreasonable restrictions or delays in the coverage.
SECTION 9. Said section 4H of said chapter 176B, as most recently amended by section 29 of chapter 127 of the acts of 2022, is hereby further amended by adding the following sentence:-
The commissioner shall ensure plan compliance with this section.
SECTION 10. Section 4I of chapter 176G of the General Laws, as most recently amended by section 31 of chapter 127 of the acts of 2022, is hereby amended by striking out the third paragraph and inserting in place thereof the following paragraph:-
Coverage provided under this section shall not be subject to any deductible, coinsurance, copayment or any other cost-sharing requirement; provided, however, that deductibles, coinsurance or copayments shall be required if the applicable plan is governed by the federal Internal Revenue Code and would lose its tax-exempt status as a result of the prohibition on deductibles, coinsurance or copayments for these services. Coverage offered under this section shall not impose unreasonable restrictions or delays in the coverage.
SECTION 11. Said section 4I of said chapter 176G, as most recently amended by section 31 of chapter 127 of the acts of 2022, is hereby amended by adding the following sentence:-
The commissioner shall ensure plan compliance with this section.
SECTION 12. Sections 1 to 11, inclusive, shall apply to all policies, contracts and certificates of health insurance subject to chapters 32A, 118E, 175, 176A, 176B and 176G of the General Laws that are delivered, issued or renewed 6 months from the effective date of this act.