Bill > S592

This bill amends the existing law in Massachusetts to increase consumer transparency about provider networks. Key provisions include: 1. Defining "network plan" as a health plan that requires or provides incentives for enrollees to use specific health care providers. 2. Defining "provider group" as a group of providers like a medical group or independent practice association. 3. Defining "tiers" or "tiered network" as a network that groups providers into different groups with varying cost-sharing or access requirements. 4. Requiring carriers (insurers) to post accurate and up-to-date electronic provider directories for each network plan, including detailed information about participating providers, hospitals, and facilities. Carriers must update these directories at least biweekly. 5. Requiring carriers to provide print provider directories upon request and to include certain disclosures in the directories. 6. Establishing processes for carriers to investigate and correct inaccuracies in provider directories reported by enrollees or the public. 7. Requiring contracts between carriers and providers to include requirements for providers to promptly inform carriers when they are not accepting new patients. The overall goal of the bill is to improve transparency around provider networks so consumers can make more informed choices about their health coverage.

Business and Industry

https://malegislature.gov/Bills/191/S592