Baker Signs Comprehensive Health Care Legislation on January 1

Gov. Charles Baker has signed a comprehensive healthcare legislation that promotes key priorities initially included in the Administration’s healthcare legislation filed in 2019.

The new law increases insurance coverage for telehealth services, expands the scope of practice for nurse practitioners, other specialized nurses, and optometrists, and takes steps to protect consumers from surprise medical bills. Recognizing the continuing impacts of COVID-19, the law also extends requirements for all insurance carriers in Massachusetts to cover COVID-19 testing and treatment.

The legislation signed contains several priorities initially included in the Baker-Polito Administration’s healthcare legislation, which was introduced in the fall of 2019, including requiring coverage of telehealth services and expanding the scope of practice for Advanced Practice Nurses. The legislation also extends, and in some instances codifies, critical measures taken through executive action throughout the pandemic to ensure timely access and coverage for COVID-19 treatment and services.

In addition to the provisions enacted, the recently signed Fiscal Year 2021 budget includes several provisions that correspond to proposals initially introduced in the Administration’s healthcare legislation. These proposals require all Massachusetts insurers to use a standard credentialing form, and prohibit additional costs for same-day billing for multiple primary care and behavioral health visits.

The key provisions of the new law include:

•Requiring coverage of telehealth services including behavioral healthcare

•Expanding Scope of Practice for Advanced Practice Nurses and Optometrists

•Increasing disclosures around provider costs and network status to protect consumers from surprise medical bills.

•Removing barriers to urgent care centers for MassHealth members.

•Extending insurance coverage and access to COVID-19 testing and treatment.

•Directing a study and report of the impacts of COVID-19 on the health care system.

“Massachusetts has long been a leader in ensuring health care quality and access and with this new law, we are making further progress in building a strong, accessible and affordable healthcare system, a goal that is more important now than ever,” said Gov. Charlie Baker. “I am proud to sign this legislation which promotes telehealth services that have become vital during this pandemic, expands access to high-quality, affordable care, takes steps to protect consumers from surprise medical bills, and preserves access to COVID-19 testing and treatment. We look forward to working with our partners in the Legislature and the health care community to build on these reforms in the future.”

Key provisions of the law signed today include:

•Strengthening Telehealth Coverage: At the start of the COVID-19 public health emergency, the Baker-Polito Administration, through emergency order, required insurers to immediately cover telehealth to ensure the continuity of services remotely when it was not safe to do so in person. This led to a rapid shift to remote delivery and significant uptake in telehealth services. The legislation builds on these emergency flexibilities, and requires coverage parity for telehealth services and implements permanent telehealth rate parity for behavioral health services.  Additionally, it requires rate parity for telehealth coverage for primary care and chronic disease management services for two years, and rate parity for all services for 90 days past the state of emergency.

•Expanding Scope of Practice: During the public health emergency, the Administration implemented emergency orders to increase health care system capacity, including temporarily expanding the scope of practice for several types of practitioners, and streamlining licensure requirements before independent practice. The new law makes permanent certain measures to expand scope of practice for nurse practitioners, nurse anesthetists, psychiatric nurse mental health specialists and optometrists. 

•Taking Steps to Address Surprise Billing: The new legislation takes steps to protect consumers from surprise bills, including a provision that requires providers to notify patients in advance as to whether a procedure is in or out of network. Additionally, it directs the Secretary of the Executive Office of Health and Human Services to work with the Health Policy Commission, Center for Health Information and Analytics, and Division of Insurance to recommend a default rate for out of network billing by September of 2021.

•Increasing Access to Urgent Care for MassHealth Members: Retail clinics and urgent care centers provide important access points to healthcare beyond the traditional hours and sites of physician offices, community health centers, and hospitals. This legislation takes several steps to increase MassHealth member access to urgent care sites, including eliminating referral requirements before urgent care visits and requirements for care coordination with the member’s primary care physician. 

•COVID-19 Related Provisions: The bill extends requirements for insurers in Massachusetts to cover COVID-19 testing and treatment. Under this legislation, insurers, including MassHealth, are required to cover all COVID-19 related emergency, inpatient, and cognitive rehab services. Additionally, coverage is required for medically necessary outpatient COVID-19 testing, including for asymptomatic individuals under specific circumstances outlined by the Secretary of the Executive Office of Health and Human Services. The legislation also directs the Health Policy Commission and Center for Health Information and Analytics to analyze and report on the effect of COVID-19 on healthcare accessibility, quality and fiscal sustainability in both the short and long term, as well as those effects on long-term policy considerations, including an examination of existing healthcare disparities due to economic, geographic, racial or other factors.

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