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PART I. ADMINISTRATION OF THE GOVERNMENT

TITLE XVII. PUBLIC WELFARE

CHAPTER 118G. HEALTH CARE FINANCE AND POLICY

Chapter 118G: Section 29. Anatomic pathology services; billing requirements

[Text of section added by 2006, 174. See also, Section 29, added by 2006, 268, Sec. 1, below.]

Section 29. (a) For the purposes of this section, the following words shall have the following meanings:-

“Anatomic pathology service”, histopathology, surgical pathology, cytopathology, hematology, sub-cellular pathology, molecular pathology and blood-banking services performed by a pathologist.

“Cytopathology”, the examination of cells from the following: (i) fluids; (ii) aspirates; (iii) washings; (iv) brushings; (v) or smears, including the pap test examination performed by a physician or under the supervision of a physician.

“Hematology”, the microscopic evaluation of bone marrow aspirates and biopsies performed by a physician or under the supervision of a physician, and peripheral blood smears when the attending or treating physician or technologist requests that a blood smear be reviewed by a pathologist.

“Histopathology or surgical pathology”, the gross and microscopic examination of organ tissue performed by a physician or under the supervision of a physician.

(b) A clinical laboratory or physician providing anatomic pathology services for patients in the commonwealth shall present or cause to be presented a claim, bill or demand for payment for these services only to the following: (i) the patient directly; (ii) the responsible insurer or other third-party payor; (iii) the hospital, public health clinic or nonprofit health clinic ordering such services; (iv) the referral laboratory or a physician’s office laboratory when the physician of such laboratory performs the anatomic pathology service; or (v) the governmental agency or its specified public or private agent, agency or organization on behalf of the recipient of the services.

(c) Except as provided under this section, no licensed practitioner shall, directly or indirectly, charge, bill or otherwise solicit payment for anatomic pathology services unless such services were rendered personally by the licensed practitioner or under the licensed practitioner’s direct supervision under section 353 of the Public Health Service Act (42 U.S.C. § 263a).

(d) No patient, insurer, third party payor, hospital, public health clinic or non-profit health clinic shall be required to reimburse any licensed practitioner for charges or claims submitted in violation of this section.

(e) Nothing in this section shall be construed to mandate the assignment of benefits for anatomic pathology services.

(f) This section shall not prohibit billing between laboratories for anatomic pathology services in instances where a sample or samples must be sent to another specialist. This paragraph shall not permit billing for anatomic pathology services of a physician’s office laboratory when the physician of such laboratory has not performed the anatomic pathology service.

(g) The board of registration in medicine may revoke, suspend or deny renewal of the license of any practitioner who violates this section.


Chapter 118G: Section 29. Personal care attendant quality home care workforce council; members

[Text of section added by 2006, 268, Sec. 1. See also, Section 29, added by 2006, 174, above.]

Section 29. (a) The PCA quality home care workforce council is established in the executive office of health and human services but shall not be subject to the control thereof to insure the quality of long-term, in-home, personal care by recruiting, training and stabilizing the work force of personal care attendants.

(b) The PCA quality home care workforce council shall consist of 9 members appointed in accordance with this section. At all times, a majority of the members of the council shall be consumers as defined in this chapter. In making appointments to the council, the governor shall appoint the secretary of health and human services or his designee as chairperson, the director of the department of workforce development or his designee and 1 member from a slate of 3 consumers recommended by the governor’s special advisory commission on disability policy. The auditor shall appoint 1 member from a slate of 3 consumers recommended by the developmental disabilities council, 1 member from a slate of 3 consumers recommended by the Massachusetts office on disability, and 1 member from a slate of 3 consumers recommended by the statewide independent living council. The attorney general shall appoint 1 member from a slate of 3 consumers or consumer surrogates recommended by the Massachusetts home care association, 1 member from a slate of 3 consumers or consumer surrogates recommended by the Massachusetts council on aging and 1 member chosen at his discretion. The secretary of the executive office of health and human services or his designee and the director of the department of workforce development or his designee shall be permanent members during their term in office. One member of the council first appointed shall serve a 1 year term, 3 shall serve a 2 year term, and 3 shall serve a 3 year term, the term of each member to be designated by the governor. Subsequent appointees to the council shall serve 3-year terms. If a vacancy occurs, the executive officer who made the original appointment shall appoint a new council member to serve the remainder of the unexpired term or, in the event that the vacancy occurs as the result of the completion of a term, to serve a full term, and such appointment shall become immediately effective upon the member taking the appropriate oath. If the departing council member was appointed pursuant to a recommendation made in accordance with this paragraph, the executive officer shall make the new appointment from a slate of 3 recommendations put forth by the entity that originally recommended the departing council member. Members of the council may serve for successive terms of office. A majority of the council shall constitute a quorum for the transaction of any business. Members of the council shall not receive compensation for their council service but members shall be reimbursed for their actual expenses necessarily incurred in the performance of their duties.