Proposed Health Benefit Mandates Currently Under Review by CHIA

  • H.B. 847: An Act relative to promoting women’s health
    • Service: requires insurers to cover annual cytologic screenings performed at the same time as an annual physical exam, so that insurers reimburse two billing codes on one visit (the annual exam and the screening). Review published May 2014 pdf format of h847-mbr-womens-health.pdf
  • H.B. 903: An Act relative to prescription eye drops
    • Service: requires insurers to cover refills of prescription eye drops in accordance with Medicare part D guidelines.
  • H.B. 915: An Act providing for certain health insurance coverage
    • Illness/ Treatment: requires insurers to cover prescription amino acid-based elemental formulas, regardless of delivery method, for the diagnosis and treatment of eosinophilic gastrointestinal disorders and short bowel syndrome.
  • H.B. 916: An Act to provide early and periodic screening, diagnosis and treatment to privately insured children under the age of 21
    • Service: requires insurers to cover early and periodic screening, diagnosis, and treatment to privately insured children under 21 in a manner equal to the amount, scope, and services provided Medicaid children and adolescents.
  • H.B. 956: An Act concerning the safety of autistic and Alzheimer individuals
    • Service: requires health plans to provide full coverage for insured individuals diagnosed with dementia, Alzheimer’s disease or Autism to obtain a Technology-Assisted Tracking Device.
  • H.B. 974: An Act relative to providing insurance coverage for breast cancer screening
    • Service: requires insurers to cover magnetic resonance imaging for certain persons for the detection of breast cancer.
  • H.B. 984: An Act relative to insurance coverage for PANDAS/PANS
    • Illness/ Treatment: requires insurers to cover treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome, including treatment with intravenous immunoglobulin.
  • H.B. 986: An Act relative to HIV-associated lipodystrophy treatment
    • Illness/Treatment: requires insurers to cover medical or drug treatments to repair disturbances of body composition caused by lipodystrophy syndrome. Review published May 2014 pdf format of h986-mbr-hiv-lipodystrophy.pdf
  • H.B. 995: An Act to improve access to alcohol and other drug clinical services
    • Practitioner Type:  expands the definition of “licensed mental health professional” who may perform certain diagnosis and treatment of certain mental health disorders to include licensed alcohol and drug counselors.
  • H.B. 1808: An Act to improve access to the services of educational psychologists
    • Practitioner Type: expands the definition of “licensed mental health professional” who may perform certain diagnosis and treatment of certain mental health disorders to include educational psychologists Review published July 2014 pdf format of h1808-educational-psychologists.pdf
  • H.B. 2051: An Act relative to the price of acupuncture
    • Service: requires insurers to cover acupuncture for pain management, PTSD, substance abuse, and nausea; also creates a commission on acupuncture and wellness.
  • S.B. 430: An Act providing health Insurance coverage for scalp hair prosthesis
    • Service: requires insurers to cover scalp hair prosthesis for those with cancer, selected alopecia conditions, or injury.
  • S.B. 471: An Act relative to pancreatic cancer screening
  • S.B. 540: An Act requiring reimbursement for the costs of providing competent interpreter services
    • Service: requires insurers to reimburse certain facilities for the cost of providing competent interpreter services through sign and spoken languages.
  • S.B. 550: An Act to provide tobacco cessation benefits
    • Treatment: requires insurers to provide tobacco cessation treatment to active and retired employees insured through the GIC and under Commonwealth Care. Review published May 2014 pdf format of s550-mbr-tobacco-cessation.pdf

Proposed Benefit Mandates Reviewed and In Effect

Click the links below to access Massachusetts General Laws. For CHIA’s review of these proposed mandates, please click here.

After December 31, 2011 (in addition to EHB)

Proposed Benefit Mandates Reviewed and Not In Effect

  • Asthma Rates
  • Senior Citizen Hearing Tests
  • Equitable Coverage for Substance Abuse
  • Marriage and Family Therapists
  • Ectodermal Dysplasia
  • Educational Psychologists
  • Eating Disorders
  • Children’s Mental Health
  • Prescription Drug Voice Synthesizers
  • Vision Screening for Children
  • Urea Cycle Disorders
  • Prescription Drug Coverage
  • Hearing Aids
  • Childhood Vaccine Program and Immunization Registry
  • Children’s Medical Security Plan
  • Colorectal Cancer Screenings
  • Women’s Health and Cancer Recovery
  • Marriage and Family Therapy
  • Craniofacial Disorders
  • Care of Patients with Mitochondrial Disease
  • Mastectomies
  • Insurance Coverage for Devic’s Disease
  • Lyme Disease treatment coverageReview published May 2014 pdf format of h989-mbr-lyme-disease.pdf