TO: Blue Cross and Blue Shield; Commercial Insurers; HMOs
FROM: Linda Ruthardt, Commissioner of Insurance
DATE: April 13, 1994
RE: New Mandated Benefits

Three new mandated benefits laws have recently been enacted that require coverage of various benefits by health insurance policies. One of these mandates, that which required coverage of bone marrow transplants for certain patients with breast cancer, required the Department of Public Health (DPH) to promulgate a regulation establishing criteria for eligibility for coverage under that- law. The purpose of this bulletin is notify health insurers, Blue Cross and Blue Shield, and HMOs that DPH has promulgated such a regulation on an emergency basis, and to inform them of the three new laws.

The DPH regulation is 105 CMR 240:000 et. seq. Criteria for Insurance Coverage of Bone Marrow Transplants for Breast Cancer Patients. Because the regulation is being filed on an emergency basis, it takes effect on its filing date, April 13, 1994. DPH will hold a public hearing within the required ninety day period following the promulgation of the emergency regulations, and it is expected that the Public Health Council, after reviewing testimony obtained through the hearing process, will promulgate final regulations at its meeting in June, 1994. Interested parties may obtain copies of the emergency regulation and information about the scheduling of the public hearing and the public comment period by calling (617) 727-2670, or by writing to Massachusetts Department of Public Health, Bureau of Environmental Monitoring, 305 South Street, Jamaica Plain, Massachusetts 02130.

The new mandated benefit laws are:

Coverage for Bone Marrow Transplants for Certain Patients with Breast CancerSt. 1993, c. 458
Reimbursement for Certified Registered Nurse Anesthetist ServicesSt. 1993, c. 332
Coverage for Certain Inherited Diseases (PKU)St. 1993, c. 384