Bill > H1162

This bill amends Section 16 of chapter 176O of the General Laws to address insurance payment practices for medical services. Specifically, the bill prohibits insurance carriers (health insurance companies) from reducing payments to healthcare providers for evaluation and management services or procedural services simply because the provider also billed other healthcare services, such as minor surgery, on the same day. The bill renders any existing contract provisions that allow such payment reductions void. Additionally, for health benefit plans where the carrier only provides administrative services, the carrier's obligation is limited to recommending coverage authorization to the third-party payor. The goal of this legislation appears to be preventing insurance companies from arbitrarily reducing reimbursements to healthcare providers, which could potentially create financial barriers or disincentives for comprehensive medical care.

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https://malegislature.gov/Bills/194/H1162