summary
Introduced
01/22/2019
01/22/2019
In Committee
07/23/2020
07/23/2020
Crossed Over
Passed
Dead
12/31/2020
12/31/2020
Introduced Session
191st General Court
Bill Summary
For legislation relative to health care non-discrimination. Health Care Financing.
AI Summary
This bill seeks to amend Chapter 176O of the Massachusetts General Laws to provide guidelines for health insurance carriers when establishing alternative payment arrangements with healthcare providers. The key provisions include: (1) Allowing carriers to consider patient population characteristics such as age, acuity, social determinants of health, and behavioral health needs when setting alternative payment arrangements, but prohibiting them from basing payments solely on provider prices or historic medical spending of a subset of their provider network; (2) Permitting carriers to include adjustments for claims processing, administrative costs, and quality/outcome-based incentive payments in alternative payment arrangements; and (3) Requiring carriers to file data on their alternative payment arrangements with the Center for Health Information and Analysis for compliance verification, with violations subject to Chapter 93A penalties.
Committee Categories
Health and Social Services
Sponsors (3)
Last Action
Ought NOT to pass (under Joint Rule 10) and placed in the Orders of the Day for the next session (on 07/23/2020)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
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State Bill Page | https://malegislature.gov/Bills/191/S719 |
Bill | https://malegislature.gov/Bills/191/S719.pdf |
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