Bill > S2138

This bill aims to protect access to confidential healthcare by requiring health insurance carriers in the commonwealth to develop and use a common summary of payments form for provider claims, written in an easily understandable format, that clearly shows a consumer's financial responsibility, with exceptions for claims solely requesting co-payments. Carriers must issue these forms at the member level and allow insured members, or those legally authorized to consent to their care, to choose their preferred delivery method, including paper mail to various addresses or secure electronic access, while ensuring compliance with data security laws like 45 CFR part 160 and 164, and Massachusetts General Laws chapters 93H and 93I, and 201 C.M.R. 17.00. Importantly, carriers are prohibited from identifying or describing sensitive health care services on these forms, with the division responsible for defining what constitutes such services after consulting with relevant experts and considering national and state regulations. Furthermore, if an insured member has no payment liability for a service, they can request that the summary of payments form be suppressed, and carriers cannot demand an explanation for this request unless legally required. The bill mandates that these rights and options be clearly communicated in plain language on all relevant documents and websites, and directs the division to create regulations for enforcement, reporting, and to collaborate with the department of public health on an educational plan for providers and consumers regarding these new provisions.