Bill > S856

This bill amends Massachusetts healthcare law to enhance protections for dually eligible individuals (people who qualify for both Medicare and Medicaid/MassHealth). The legislation ensures that these individuals can receive healthcare services from any specialist or hospital in Massachusetts that participates in Medicare or MassHealth, regardless of their specific health plan's network restrictions. If a health plan does not already have a contract with a provider, the provider will be reimbursed at the Medicare or MassHealth fee-for-service rate. Additionally, the bill requires One Care or Senior Care Options (SCO) plans to maintain continuity of care by allowing members to continue receiving services from their current providers for 12 months following a contract termination, maintaining the same contractual terms that were in place before the termination. This provision aims to protect vulnerable patients from disruptions in their healthcare services and ensure they can maintain relationships with their existing healthcare providers, while also preventing plans and providers from avoiding good faith contract negotiations.

Health and Social Services

https://malegislature.gov/Bills/194/S856