By Mr. Moore, a petition (accompanied by bill, Senate,
No. 611) of Richard T. Moore for legislation to facilitate
private insurance coverage and benefits. Financial
Services. |
By Mr. Moore, a petition (accompanied by bill, Senate,
No. 611) of Richard T. Moore for legislation to facilitate
private insurance coverage and benefits. Financial
Services. |
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: Application of the Act
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.
