Bill > H1189

This bill requires health insurance providers in Massachusetts to provide comprehensive coverage for individuals diagnosed with Alfi's syndrome, a rare genetic condition also known as 9p deletion syndrome. The bill mandates that all state-regulated health insurance policies must offer non-discriminatory benefits for diagnosing and treating the syndrome, including habilitative or rehabilitative care, pharmacy care, psychiatric and psychological care, and therapeutic services. The coverage must be provided without annual or lifetime dollar limitations that are less restrictive than those for physical conditions, and there can be no limits on the number of visits to Alfi's syndrome service providers. Insurers may be temporarily exempted from providing certain coverage if an actuary certifies that the additional services would increase premiums by more than 1%, with the exemption lasting up to three years. The bill applies to various types of health insurance policies, including state employee plans, individual and group policies, and health maintenance organization contracts, and is set to take effect on January 1, 2024, with insurance policies delivered, issued, or renewed after that date required to comply with the new provisions.

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https://malegislature.gov/Bills/194/H1189