Bill > H4338

This bill modifies Section 16 of Chapter 176O of Massachusetts General Laws to prevent health insurance carriers (insurance companies) from reducing payments to healthcare providers for evaluation and management or procedural services simply because the provider billed other healthcare services on the same day. Specifically, the bill prohibits carriers from automatically reducing negotiated rates when a provider bills for multiple services simultaneously, such as an evaluation and a minor surgical procedure performed during the same patient visit. The bill also clarifies that any provider agreement containing provisions that would allow such rate reductions is considered 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 actual third-party payor. The intent of this legislation appears to be protecting healthcare providers from unfair payment reductions and ensuring they are fairly compensated for comprehensive patient care.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H4338