H1342 — An Act relative to parental choice for medically fragile students

Summary

An Act relative to parental choice for medically fragile students

Bill Text

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The bill mandates that various insurance policies provide nondiscriminatory benefits for medically necessary treatments required by specific educational plans for students with disabilities.

• Chapter 32A

  Section 33. The commission shall provide to an active or retired employee of the commonwealth who is insured under the group insurance commission benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

  This introduces a new section that requires benefits to be provided for certain medical treatments for employees insured under the group insurance commission.

• Chapter 175

  Section 47UU. An individual policy of accident and sickness insurance issued under section 108 that provides hospital expense and surgical expense insurance and any group blanket or general policy of accident and sickness insurance issued under section 110 that provides hospital expense and surgical expense insurance, which is issued or renewed within or without the commonwealth, shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

  This creates a new section requiring certain accident and sickness insurance policies to provide nondiscriminatory coverage for specific medical treatments.

• Chapter 176A

  Section 8VV. A contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

  This adds a requirement for hospital service plans to include nondiscriminatory benefits for medically necessary treatments.

• Chapter 176B

  Section 4PP. A subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury, or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

  This introduces a new section ensuring that medical service agreements provide necessary treatment benefits.

• Chapter 176G

  Section 4HH. A health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for the medically necessary treatment for disease, illness, injury or bodily dysfunction which are required by a student’s individual education program, individualized family service plan, individualized service plan or the federal Individuals with Disabilities Education Improvement Act.

  This adds a requirement for health maintenance contracts to provide nondiscriminatory coverage for certain medical treatments.

• All policies, contracts and certificates of health insurance subject to section 33 of chapter 32A, section 47UU of chapter 175, section 8VV of chapter 176A, section 4PP of chapter 176B, and section 4HH of chapter 176G of the General Laws which are delivered, issued or renewed on or after January 1, 2015 shall conform with the provisions of this act. Form filings implementing this act shall be subject to the approval of the commissioner of insurance.

  This section establishes conformity requirements for insurance policies and contracts in relation to the new sections added.

Sponsors

• Tommy Vitolo · Primary

Subjects