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| 2 | 2 | | HOUSE DOCKET, NO. 914 FILED ON: 1/14/2025 |
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| 3 | 3 | | HOUSE . . . . . . . . . . . . . . . No. 1168 |
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| 4 | 4 | | The Commonwealth of Massachusetts |
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| 5 | 5 | | _________________ |
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| 6 | 6 | | PRESENTED BY: |
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| 7 | 7 | | Judith A. Garcia |
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| 8 | 8 | | _________________ |
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| 9 | 9 | | To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General |
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| 10 | 10 | | Court assembled: |
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| 11 | 11 | | The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: |
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| 12 | 12 | | An Act relative to eliminating the PCP referral requirement for specialty gynecological care. |
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| 13 | 13 | | _______________ |
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| 14 | 14 | | PETITION OF: |
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| 15 | 15 | | NAME:DISTRICT/ADDRESS :DATE ADDED:Judith A. Garcia11th Suffolk1/14/2025Patrick Joseph Kearney4th Plymouth1/22/2025 1 of 1 |
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| 16 | 16 | | HOUSE DOCKET, NO. 914 FILED ON: 1/14/2025 |
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| 17 | 17 | | HOUSE . . . . . . . . . . . . . . . No. 1168 |
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| 18 | 18 | | By Representative Garcia of Chelsea, a petition (accompanied by bill, House, No. 1168) of |
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| 19 | 19 | | Judith A. Garcia and Patrick Joseph Kearney relative to eliminating the health insurance referral |
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| 20 | 20 | | requirement for certain specialty gynecological care. Financial Services. |
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| 21 | 21 | | The Commonwealth of Massachusetts |
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| 22 | 22 | | _______________ |
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| 23 | 23 | | In the One Hundred and Ninety-Fourth General Court |
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| 24 | 24 | | (2025-2026) |
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| 25 | 25 | | _______________ |
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| 26 | 26 | | An Act relative to eliminating the PCP referral requirement for specialty gynecological care. |
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| 27 | 27 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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| 28 | 28 | | of the same, as follows: |
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| 29 | 29 | | 1 Subsection (g) of section 15 of chapter 176O of the General Laws, as appearing in the |
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| 30 | 30 | | 22022 Official Edition, is hereby amended by striking out the first sentence and inserting in place |
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| 31 | 31 | | 3thereof the following sentence:- No carrier shall require an insured to obtain a referral or prior |
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| 32 | 32 | | 4authorization from a primary care provider for specialty care provided by an obstetrician, |
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| 33 | 33 | | 5gynecologist, certified nurse-midwife or family practitioner participating in such carrier's health |
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| 34 | 34 | | 6care provider network for the following: (i) annual preventive gynecologic health examinations, |
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| 35 | 35 | | 7including any subsequent obstetric or gynecological services determined by such obstetrician, |
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| 36 | 36 | | 8gynecologist, certified nurse-midwife or family practitioner to be medically necessary as a result |
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| 37 | 37 | | 9of such examination; (ii) preventative gynecologic health care and menstrual health conditions |
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| 38 | 38 | | 10such as abnormal uterine bleeding, dysmenorrhea and pelvic pain; (iii) maternity care; and (iv) |
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| 39 | 39 | | 11medically necessary evaluations and resultant health care services for acute or emergency |
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| 40 | 40 | | 12gynecological conditions. |
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