By Mr. Moore, a petition (accompanied by bill, Senate,
No. 690) of Richard T. Moore for legislation to require
notification of patient financial responsibility. Health
Care Financing. |
By Mr. Moore, a petition (accompanied by bill, Senate,
No. 690) of Richard T. Moore for legislation to require
notification of patient financial responsibility. Health
Care Financing. |
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 24B of chapter 175 of the general laws, as appearing in the 2004 official edition, is hereby amended by inserting after the first paragraph the following paragraph:
The commissioner shall also require health care insurers, including any self-insured sickness, health, or welfare plan under this section, to recover all payments due from patients for covered services when the total payments due is greater than two thousand dollars. For purposes of this section, payments due from patients for covered services include co-payments, deductibles and co-insurance. Said health care insurers shall include payments due from patients for covered health care services in their payments to providers. Nothing in this section shall prohibit providers and insurers from mutually agreeing to alternative billing and payment processes when it has been determined that the patient has or can obtain secondary insurance coverage for the services provided.
SECTION 2: Section 6 of Chapter 176O of the General Laws, as so appearing, is hereby amended by striking out subsection (a)(3) and inserting in its place thereof the following subsection:
(a)(3) limitations on the scope of coverage for health care services and any other benefits to be provided, all restrictions related to preexisting conditions of exclusions, and clear and understandable information regarding the insured’s financial obligations under the health benefit plan, including specific examples of: each co-payment amount that the insured may be subject to under the health benefit plan; applicable deductibles; and coinsurance amounts and a clear explanation of the consequences that will result from the insured’s failure to pay the proscribed financial obligations;
SECTION 3: Section 6 of Chapter 176O of the General Laws, as so appearing, is hereby amended by inserting at the end of subsection (a)(4) the following words:
“, including, if so requested, disclosure of the insured’s financial obligation at that location prior to the time non-emergency health care services are delivered;”
SECTION 4: The Commissioner of Insurance shall promulgate regulations to enforce the provisions of this Act no later than 120 days after the effective date of the Act. Such regulations shall be effective for provider contracts and an enrollees’ policies which are entered into, renewed, or amended on or after the regulations effective date.
