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| 2 | 2 | | HOUSE DOCKET, NO. 3215 FILED ON: 1/16/2025 |
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| 3 | 3 | | HOUSE . . . . . . . . . . . . . . . No. 1299 |
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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 | | David Allen Robertson |
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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 to increase enrollment in affordable health plan networks. |
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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:David Allen Robertson19th Middlesex1/16/2025 1 of 2 |
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| 16 | 16 | | HOUSE DOCKET, NO. 3215 FILED ON: 1/16/2025 |
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| 17 | 17 | | HOUSE . . . . . . . . . . . . . . . No. 1299 |
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| 18 | 18 | | By Representative Robertson of Tewksbury, a petition (accompanied by bill, House, No. 1299) |
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| 19 | 19 | | of David Allen Robertson for legislation to increase enrollment in affordable health plan |
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| 20 | 20 | | networks. Financial Services. |
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| 21 | 21 | | [SIMILAR MATTER FILED IN PREVIOUS SESSION |
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| 22 | 22 | | SEE HOUSE, NO. 1125 OF 2023-2024.] |
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| 23 | 23 | | The Commonwealth of Massachusetts |
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| 24 | 24 | | _______________ |
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| 25 | 25 | | In the One Hundred and Ninety-Fourth General Court |
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| 26 | 26 | | (2025-2026) |
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| 27 | 27 | | _______________ |
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| 28 | 28 | | An Act to increase enrollment in affordable health plan networks. |
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| 29 | 29 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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| 30 | 30 | | of the same, as follows: |
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| 31 | 31 | | 1 SECTION 1. Subsection (a) of section 11 of chapter 176J of the General Laws is hereby |
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| 32 | 32 | | 2amended by inserting at the end thereof the following:- |
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| 33 | 33 | | 3 The commissioner may also exempt carriers from complying with this section based on |
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| 34 | 34 | | 4(i) whether the majority of a carrier’s chapter 176J membership is enrolled in a single rate |
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| 35 | 35 | | 5region; or (ii) whether the majority of the carrier’s chapter 176J membership is enrolled in |
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| 36 | 36 | | 6subsidized coverage offered under chapter 176Q through which such members receive state or |
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| 37 | 37 | | 7federal subsidies; or (iii) whether the carrier receives 80 per cent or more of its income from |
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| 38 | 38 | | 8government programs, including subsidized coverage offered under chapter 176Q through which |
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| 39 | 39 | | 9such members receive state or federal subsidies. 2 of 2 |
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| 40 | 40 | | 10 SECTION 2. Section 9A of chapter 176O of the General Laws is hereby amended by |
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| 41 | 41 | | 11striking out subsection (a) and inserting in place thereof the following subsection:- |
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| 42 | 42 | | 12 "(a)(i) limits the ability of the carrier to introduce or modify a select network plan or |
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| 43 | 43 | | 13tiered network plan by granting the health care provider a guaranteed right of participation; (ii) |
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| 44 | 44 | | 14requires the carrier to place all members of a provider group, whether local practice groups or |
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| 45 | 45 | | 15facilities, in the same tier of a tiered network plan; or (iii) requires the carrier to include all |
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| 46 | 46 | | 16members of a provider group, whether local practice groups or facilities, in a select network plan |
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| 47 | 47 | | 17on an all-or-nothing basis; or" |
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