Bill > H4342

This bill requires health insurance providers in Massachusetts to include reimbursement for medically appropriate evaluation and management services in outpatient settings (such as office and hospital-based clinics) as part of their basic benefits package without requiring a deductible. The bill amends several chapters of Massachusetts General Laws, including those governing state employee insurance (Chapter 32A and 32B), various types of insurance policies (Chapters 175, 176A, 176B, and 176G), to ensure consistent coverage. The guidelines for these services will be developed by the division of insurance. There is a notable exception: if a health plan is governed by the Federal Internal Revenue Code and would lose its tax-exempt status by eliminating deductibles, then a deductible may be required. By mandating coverage without upfront costs for these evaluation and management services, the bill aims to improve access to healthcare by reducing financial barriers to receiving medical care in outpatient settings.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H4342