January 28, 2021
Described by Governor Charlie Baker as a "silver lining" to the pandemic, a new health care bill was recently signed into law. The Act to Promote a Resilient Health Care System that Puts Patients First contains numerous provisions designed to address immediate needs resulting from the COVID-19 pandemic, as well as fundamental changes to the state's health care system.
The new law addresses telehealth, but distinguishes between behavioral health services and other care needs. For behavioral health services, the law makes permanent rate parity provisions that have been in place during the current public health emergency; behavioral health providers must be paid by insurers at the same amount for telehealth services as for those provided in person.
On the contrary, there is concern that non-behavioral health telehealth sessions can increase costs if a telehealth consultation simply delays rather than replaces an in-person visit. For this reason, the law requires rate parity for primary and chronic illness care for only two years, giving the state time to study and understand the effect on patient outcomes and the overall cost of care.
Other provisions in the law address surprise billing by increasing transparency to consumers about insurance networks; increase access to care by expanding the scope of practice for certain medical professionals; require insurance coverage for certain pediatric conditions; and lessen barriers for Mass Health patients seeking urgent care. Additionally, the law requires that medically necessary COVID-19 testing and related treatment be provided at no cost to consumers.
A brief overview of the new law was written by the Massachusetts Association for Mental Health, and the full text can be found here.