Bill > S645

This bill aims to address out-of-network billing practices in Massachusetts. The key provisions are: 1. It requires the Center for Health Information and Analysis to calculate the "noncontracted commercial rate" for emergency and non-emergency services provided by out-of-network healthcare providers. This rate will be used to determine the payment to the provider, and the provider cannot bill the patient for any amount beyond the applicable copay, coinsurance, or deductible. 2. It prohibits healthcare providers and carriers from requesting payment from patients beyond the applicable cost-sharing amounts for the services covered under the law. 3. It allows self-funded health plans to opt-in to the provisions of the law, which would then apply to their plan members. 4. The Division of Insurance is required to establish and implement these new rates by July 31, 2024, based on the recommendations from the Secretary of Health and Human Services. The overall goal of the bill is to protect patients from surprise medical bills and improve transparency around out-of-network billing practices in the state.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/193/S645