Bill > H4961

This bill aims to improve healthcare access for individuals requiring ostomy care by mandating that various health insurance providers, including the Group Insurance Commission, Medicaid managed care organizations, and private insurers, cover all necessary medical supplies for managing fistulas and ostomy care, without requiring the use of non-medical alternatives. It also ensures continuity of care by requiring the transfer of patient information within 72 hours when a person switches health insurance, preventing delays in ostomy supply orders and shipments during transitions, and mandates that healthcare payers reimburse ostomy supply providers at a rate no less than Medicare reimbursement rates. Furthermore, the bill requires acute-care hospitals performing ostomy surgery to have access to certified ostomy care professionals and to offer ongoing follow-up care, while also establishing that prescriptions for ostomy supplies are valid for at least one year, allowing physicians to prescribe quantities exceeding limits if medically necessary, and prohibiting delays in prescription fulfillment due to approval processes. Finally, suppliers must provide one month's advance notice before a prescription expires or if they intend to substitute ostomy supply brands, known as "non-medical switching," and if a substitute product compromises patient care, the patient has the option to return to their original product or receive a comparable quality alternative.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H4961