By Mr. Mariano of Quincy, petition (accompanied by bill, House, No. 1020) of Ronald Mariano relative to private insurance coverage and benefits.  Financial Services.

 

The Commonwealth of Massachusetts

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PETITION OF:

 


Ronald Mariano

 

 


 

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In the Year Two Thousand and Seven.

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 An Act facilitating private insurance coverage and benefits.

 

    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:  Section 5 of Chapter 176O of the General Laws, as appearing in the 2004 official edition, is hereby amended by inserting after the first paragraph the following paragraph:

No carrier, including a dental or vision carrier, shall require a health, dental or vision care provider to participate in all of its health benefit plans or product offerings.  A provider shall be given the opportunity to expressly accept or decline participation in a new product and such refusal to participate in a new product shall not affect participation in existing contracts or participation in the carrier’s provider network.  A provider shall also be given the opportunity to expressly accept or reject changes to fee schedules or capitation rates; billing or payment policies and terms; and any payment related administrative requirements prior to the carrier’s amending such terms in existing contracts. 

 

SECTION 2: 

The provisions of this Act shall be included in all contracts between a carrier and a health care provider entered into, renewed, or amended on or after the effective date of this Act.