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SENATE DOCKET, NO. 1592 FILED ON: 1/16/2025
SENATE . . . . . . . . . . . . . . No. 783
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Joan B. Lovely
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to promote increased access to patient care through equitable reimbursement.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Joan B. LovelySecond Essex 1 of 10
SENATE DOCKET, NO. 1592 FILED ON: 1/16/2025
SENATE . . . . . . . . . . . . . . No. 783
By Ms. Lovely, a petition (accompanied by bill, Senate, No. 783) of Joan B. Lovely for
legislation to promote increased access to patient care through equitable reimbursement.
Financial Services.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act to promote increased access to patient care through equitable reimbursement.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 32A of the General Laws, as appearing in the 2024 Official
2Edition, is hereby amended by adding the following section:—
3 Section 34. (a) (1) Coverage offered by the commission to an active or retired employee
4of the commonwealth insured under the commission shall not make a distinction, for the
5purposes of participation, coverage, and payment, between physicians licensed pursuant to
6chapter 112 and certified registered nurse anesthetists authorized to practice in an advanced
7practice nursing role pursuant to section 80B of chapter 112, if the physician or certified
8registered nurse anesthetist is acting within the scope of their practice pursuant to their licensure
9and certification. Nothing in this subsection shall prevent the commission from establishing
10varying reimbursement rates based on quality or performance measures if such measures are the
11same for physicians licensed pursuant to chapter 112 and certified registered nurse anesthetists
12authorized to practice in advanced practice nursing roles pursuant to said section 80B. 2 of 10
13 (b) A claim submitted for payment must identify the National Provider Identifier of the
14physician or certified registered nurse anesthetist who provided the service.
15 (c) (1) The commission shall reimburse a contracted certified registered nurse anesthetist
16who is authorized to practice in an advanced practice nursing role pursuant to said section 80B in
17an amount not less than the allowed amount that the commissioner would reimburse for the same
18service if provided by a contracted provider who is a physician licensed pursuant to chapter 112.
19 (2) The commission may not reduce the reimbursement amount paid to physicians
20licensed under chapter 112 to comply with this subsection.
21 SECTION 2. Section 6 of chapter 118E of the General Laws, as so appearing, is hereby
22amended by inserting in line __ after the words “board-certified physicians”, the following:—
23 , certified registered nurse anesthetists,
24 SECTION 3. Chapter 118E of the General Laws, as so appearing, is hereby amended by
25adding the following section:—
26 Section 83. (a) (1) The division and its contracted health insurers, health plans, health
27maintenance organizations, behavioral health management firms and third-party administrators
28under contract to a Medicaid-managed care organization, accountable care organization, or
29primary care clinician plan shall not make a distinction, for the purposes of participation,
30coverage, and payment, between physicians licensed pursuant to chapter 112 and certified
31registered nurse anesthetists authorized to practice in an advanced practice nursing role pursuant
32to section 80B of chapter 112, if the physician or certified registered nurse anesthetist is acting
33within the scope of their practice pursuant to their licensure and certification. Nothing in this 3 of 10
34subsection shall prevent the commission from establishing varying reimbursement rates based on
35quality or performance measures if such measures are the same for physicians licensed pursuant
36to chapter 112 and certified registered nurse anesthetists authorized to practice in advanced
37practice nursing roles pursuant to said section 80B.
38 (b) A claim submitted for payment must identify the National Provider Identifier of the
39physician or certified registered nurse anesthetist who provided the service.
40 (c) The division and its contracted entities shall: (i) reimburse a contracted certified
41registered nurse anesthetist who is authorized to practice in an advanced practice nursing role
42pursuant to said section 80B in an amount not less than the allowed amount that it would
43reimburse for the same service if provided by a contracted provider who is a physician licensed
44pursuant to chapter 112; and (ii) not reduce the reimbursement amount paid to physicians
45licensed under chapter 112 to comply with this subsection.
46 SECTION 4. Chapter 175 of the General Laws, as so appearing, is hereby amended by
47inserting after section 108N the following section: —
48 Section 108O. (a) (1) An individual policy of accident and sickness insurance issued
49under section 108 that provides hospital expense and surgical expense insurance and any group
50blanket or general policy of accident and sickness insurance issued under section 110 that
51provides hospital expense and surgical expense insurance that is issued or renewed within or
52without the commonwealth shall not make a distinction, for the purposes of participation,
53coverage, and payment, between physicians licensed pursuant to chapter 112 and certified
54registered nurse anesthetists authorized to practice in an advanced practice nursing role pursuant
55to section 80B of chapter 112, if the physician or certified registered nurse anesthetist is acting 4 of 10
56within the scope of their practice pursuant to their licensure and certification. Nothing in this
57subsection shall prevent the commission from establishing varying reimbursement rates based on
58quality or performance measures as long as such measures are the same for physicians licensed
59pursuant to chapter 112 and certified registered nurse anesthetists authorized to practice in an
60advanced practice nursing role pursuant to said section 80B.
61 (b) A claim submitted for payment must identify the National Provider Identifier of the
62physician or certified registered nurse anesthetist who provided the service.
63 (c) An individual policy of accident and sickness insurance issued under section 108 that
64provides hospital expense and surgical expense insurance and any group blanket or general
65policy of accident and sickness insurance issued under section 110 that provides hospital expense
66and surgical expense insurance that is issued or renewed within or without the commonwealth
67shall: (i) reimburse a contracted certified registered nurse anesthetist who is authorized to
68practice in an advanced practice nursing role pursuant to said section 80B in an amount not less
69than the allowed amount that it would reimburse for the same service if provided by a contracted
70provider who is a physician licensed pursuant to chapter 112; and (ii) not reduce the
71reimbursement amount paid to physicians licensed under chapter 112 to comply with this
72section.
73 SECTION 5. Chapter 176A of the General Laws, as so appearing, is hereby amended by
74adding the following section:—
75 Section 39. Any contract between a subscriber and a corporation under an individual or
76group hospital service plan delivered, issued or renewed within the commonwealth shall not
77make a distinction, for the purposes of participation, coverage, and payment, between physicians 5 of 10
78licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized to practice
79in an advanced practice nursing role pursuant to section 80B of chapter 112, if the physician or
80certified registered nurse anesthetist is acting within the scope of their practice pursuant to their
81licensure and certification. Nothing in this subsection shall prevent the commission from
82establishing varying reimbursement rates based on quality or performance measures if such
83measures are the same for physicians licensed pursuant to chapter 112 and certified registered
84nurse anesthetists authorized to practice in an advanced practice nursing role pursuant to said
85section 80B.
86 (b) A claim submitted for payment must identify the National Provider Identifier of the
87physician or certified registered nurse anesthetist who provided the service.
88 (c) Any contract between a subscriber and a corporation under an individual or group
89hospital service plan delivered, issued or renewed within the commonwealth shall: (i) reimburse
90a contracted certified registered nurse anesthetist who is authorized to practice in an advanced
91practice nursing role pursuant to said section 80B in an amount not less than the allowed amount
92that it would reimburse for the same service if provided by a contracted provider who is a
93physician licensed pursuant to chapter 112; and (ii) not reduce the reimbursement amount paid to
94physicians licensed under chapter 112 to comply with this section.
95 SECTION 6. Section 1 of chapter 176B of the General Laws, as so appearing, is hereby
96amended by inserting after the definition of “'Certified nurse midwife'', the following
97definition:— 6 of 10
98 “Certified registered nurse anesthetist”, a registered nurse who is authorized to practice in
99an advanced practice nursing role as a certified registered nurse anesthetist pursuant to section
10080B of chapter 112.
101 SECTION 7. Section 1 of said chapter 176B is hereby further amended by inserting after
102“physicians” in the definition of “Medical service” the following:—
103 or certified registered nurse anesthetists
104 SECTION 8. Section 1 of said chapter 176B is further amended by inserting, after the
105definition of “Nonprofit medical service plan”, the following definition: —
106 “Participating certified registered nurse anesthetist”, a certified registered nurse
107anesthetist who is authorized to practice in an advanced practice nursing role pursuant to section
10880B of chapter 112, and who agrees in writing with a medical service corporation to perform
109medical services for subscribers and covered dependents and to abide by the by-laws, rules and
110regulations of such corporation.
111 SECTION 9. Said chapter 176B is further amended in section 4T by striking out,
112wherever they appear, the words “certified registered nurse anesthetist or”.
113 SECTION 10. Said chapter 176B is hereby further amended by adding the following
114section:—
115 Section 26. A contract between a subscriber and a medical service corporation shall not
116make a distinction, for the purposes of participation, coverage, and payment, between physicians
117licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized to practice
118in an advanced practice nursing role pursuant to section 80B of chapter 112, if the physician or 7 of 10
119certified registered nurse anesthetist is acting within the scope of their practice pursuant to their
120licensure and certification. Nothing in this subsection shall prevent the commission from
121establishing varying reimbursement rates based on quality or performance measures if such
122measures are the same for physicians licensed pursuant to chapter 112 and certified registered
123nurse anesthetists authorized to practice in an advanced practice nursing role pursuant to said
124section 80B.
125 (b) A claim submitted for payment must identify the National Provider Identifier of the
126physician or certified registered nurse anesthetist who provided the service.
127 (c) A contract between a subscriber and a medical service corporation shall: (i) reimburse
128a contracted certified registered nurse anesthetist who is authorized to practice in an advanced
129practice nursing role pursuant to said section 80B in an amount not less than the allowed amount
130that it would reimburse for the same service if provided by a contracted provider who is a
131physician licensed pursuant to chapter 112; and (ii) not reduce the reimbursement amount paid to
132physicians licensed under chapter 112 to comply with this section.
133 SECTION 11. Section 1 of chapter 176G of the General Laws, as so appearing, is hereby
134amended by inserting the following definition: —
135 “Certified registered nurse anesthetist”, A certified registered nurse anesthetist who is
136authorized to practice in an advanced practice nursing role pursuant to section 80B of chapter
137112.
138 SECTION 12. Section 1 of said chapter 176G is hereby further amended by inserting
139after the word “physician”, in the definition of “Health services”, the following:— 8 of 10
140 or certified registered nurse anesthetist
141 SECTION 13. Chapter 176G of the General Laws, as so appearing, is hereby amended by
142adding the following section:-
143 Section 34. A contract between a member and a health maintenance organization shall
144not make a distinction, for the purposes of participation, coverage, and payment, between
145physicians licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized
146to practice in an advanced practice nursing role pursuant to section 80B of chapter 112, if the
147physician or certified registered nurse anesthetist is acting within the scope of their practice
148pursuant to their licensure and certification. Nothing in this subsection shall prevent the
149commission from establishing varying reimbursement rates based on quality or performance
150measures as long as such measures are the same for physicians licensed pursuant to chapter 112
151and certified registered nurse anesthetists authorized to practice in an advanced practice nursing
152role pursuant to said section 80B
153 (b) A claim submitted for payment must identify the National Provider Identifier of the
154physician or certified registered nurse anesthetist who provided the service.
155 (c) A contract between a member and a health maintenance organization shall: (i)
156reimburse a contracted certified registered nurse anesthetist who is authorized to practice in an
157advanced practice nursing role pursuant to said section 80B in an amount not less than the
158allowed amount that it would reimburse for the same service if provided by a contracted provider
159who is a physician licensed pursuant to chapter 112; and (ii) not reduce the reimbursement
160amount paid to physicians licensed under chapter 112 to comply with this section. 9 of 10
161 SECTION 14. Chapter 176G of the General Laws is hereby further amended by adding
162the following section:—
163 Section 35. When a law or rule requires authorization or involvement of a physician as a
164condition of reimbursement or coverage of anesthesia services, that requirement may be fulfilled
165by a certified registered nurse anesthetist practicing in an advanced practice role under section
16680B of chapter 112.
167 SECTION 15. Chapter 176I of the General Laws is hereby amended by adding the
168following section:-
169 Section 14. A preferred provider contract between a covered person and an organization
170shall not make a distinction, for the purposes of participation, coverage, and payment, between
171physicians licensed pursuant to chapter 112 and certified registered nurse anesthetists authorized
172to practice in an advanced practice nursing role pursuant to section 80B of said chapter 112, if
173the physician or advanced practice registered nurse is acting within the scope of their practice
174pursuant to their licensure and certification. Nothing in this subsection shall prevent the
175commission from establishing varying reimbursement rates based on quality or performance
176measures as long as such measures are the same for physicians licensed pursuant to chapter 112
177and certified registered nurse anesthetists practicing authorized to practice in an advanced
178practice nursing role pursuant to section 80B of said chapter 112.
179 (b) A claim submitted for payment must identify the National Provider Identifier of the
180physician or advanced practice registered nurse who provided the service.
181 (c) A preferred provider arrangement between a covered person and an organization
182shall: (i) reimburse a preferred provider certified registered nurse anesthetist who is authorized to 10 of 10
183practice in an advanced practice nursing role pursuant to section 80B of chapter 112 in an
184amount not less than the allowed amount that it would reimburse for the same service if provided
185by a preferred provider who is a physician licensed pursuant to said chapter 112; and (ii) not
186reduce the reimbursement amount paid to physicians licensed under chapter 112 to comply with
187this section.