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| 2 | 2 | | HOUSE DOCKET, NO. 904 FILED ON: 1/13/2025 |
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| 3 | 3 | | HOUSE . . . . . . . . . . . . . . . No. 1295 |
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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 | | Sean Reid |
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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 promoting consumer choice in health 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:Sean Reid11th Essex1/13/2025 1 of 2 |
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| 16 | 16 | | HOUSE DOCKET, NO. 904 FILED ON: 1/13/2025 |
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| 17 | 17 | | HOUSE . . . . . . . . . . . . . . . No. 1295 |
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| 18 | 18 | | By Representative Reid of Lynn, a petition (accompanied by bill, House, No. 1295) of Sean Reid |
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| 19 | 19 | | for legislation to require insurance companies to reimburse licensed athletic trainers for certain |
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| 20 | 20 | | services. 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 promoting consumer choice in health 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 Chapter 175 of the General Laws is hereby amended by adding at the end of said Chapter |
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| 30 | 30 | | 2the following section: |
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| 31 | 31 | | 3 SECTION__A licensed athletic trainer, acting with a referral from a physician, who acts |
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| 32 | 32 | | 4within the scope of practice authorized by law shall not be denied reimbursement by the health |
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| 33 | 33 | | 5insurer for those covered services if the health insurer would reimburse another health care |
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| 34 | 34 | | 6provider for those services. This Section pertains only to those health plans that provide coverage |
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| 35 | 35 | | 7for a particular type of health service, or for any particular medical condition that is within the |
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| 36 | 36 | | 8scope of practice of licensed athletic trainers. |
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| 37 | 37 | | 9 Services provided by licensed athletic trainers may be subject to reasonable deductibles, |
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| 38 | 38 | | 10co-payment and co-insurance amounts, fee or benefit limits, practice parameters, and utilization |
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| 39 | 39 | | 11review consistent with applicable rules adopted by the Division of Insurance; provided that the |
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| 40 | 40 | | 12amounts, limits, and review shall not function to direct treatment in a manner unfairly 2 of 2 |
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| 41 | 41 | | 13discriminative against athletic trainer care, and collectively shall be no more restrictive than |
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| 42 | 42 | | 14those applicable under the same policy for care or services provided by other health care |
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| 43 | 43 | | 15providers. |
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| 44 | 44 | | 16 Nothing in this Section shall be construed as impeding or preventing either the provision |
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| 45 | 45 | | 17or coverage of health care services by licensed athletic trainers within the lawful scope of athletic |
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| 46 | 46 | | 18trainer practice. |
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| 47 | 47 | | 19 |
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| 48 | 48 | | 20 As used in this section, “health insurance plan” means an individual or group health |
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| 49 | 49 | | 21insurance policy, a hospital or medical service corporation or health maintenance organization |
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| 50 | 50 | | 22subscriber contract, or another health benefit plan offered, issued, or renewed for a person by a |
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| 51 | 51 | | 23health insurer. The term shall not include benefit plans providing coverage for specific disease or |
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| 52 | 52 | | 24other limited benefit coverage. |
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