Comprehensive legislation addresses health care cost inequities, consumer protections and transparency


State Representative Christine P. Barber joined her house colleagues last week in passing H.4639, An Act establishing the Honorable Peter V. Kocot Act to enhance access to high quality, affordable, and transparent health care in the Commonwealth. The bill, named in honor of the late Chairman of Health Care Financing, takes significant steps to tackle cost inequities, consumer protections, and transparency in health care, and addresses three critical health care priorities on which Rep. Barber has focused this legislative session.Rep. Barber has worked for months to gain support from various stakeholders on health care issues affecting residents of the Commonwealth that were included in the House bill. After filing H.2947, An Act to increase consumer transparency about insurance provider networks, Rep. Barber worked to bring advocates, including the Children’s Mental Health Campaign and Health Care For All, providers, and insurers together to develop compromise language that addresses the increasingly prevalent problem of ghost networks – inaccurate lists of providers in a network who have close their practices, are no longer accepting patients, or do not specialize in the right care. As a result of these outdated provider directories, families and individuals often cannot find the right care in their network when they need it.

“I was proud to file an amendment to the House’s health care bill requiring insurers to make timely updates to their provider directories, and see it adopted,” said Representative Barber. “Ghost networks present a serious barrier to care, particularly for behavioral health. We can all do more to make sure families have accurate resources when seeking health services.”

“This is an important, common sense step towards improving prompt access to behavioral health care, as well as many other critical health care services, for children and families,” said Courtney Chelo, campaign manager for the Children’s Mental Health Campaign.

As a member of the Massachusetts Autism Commission, Representative Barber has worked with autism advocates and insurers on fixing a loophole in state law to ensure disabled adults and adults with developmental disabilities are able to stay on their parents’ insurance plans over age 26. Adopted as an amendment to the House’s health care bill, this fix ensures all health plans in Massachusetts are required to offer this continuous coverage. “While this is the policy many health plans in Massachusetts already follow, it is important to update our laws to ensure no families are dropped from coverage they depend on,” said Representative Barber.

“Adults with disabilities will have more options to meet their health care needs as a result of this bill,” said Wells Wilkinson of Health Law Advocates, a non-profit public interest law firm that represents Massachusetts consumers denied access to health care. “Health care services can be particularly difficult to access for individuals with developmental or behavioral health disabilities, so it is critical for them to have continuity in their health insurance. We applaud Representative Barber for her strong leadership on this issue.”

Rep. Barber has also focused this session on increasing transparency around pharmaceutical drug costs, one of the fastest-growing costs in the health system. Barber filed H.3223, An Act to promote transparency in prescription drug costs, and has advocated for several important measures that will make pharmaceutical manufacturing companies more transparent in their cost setting processes and help identify high cost drugs impacting the state’s cost growth. Requiring pharmaceutical manufacturing companies to testify before the Health Policy Commission during its annual cost trends hearings, identifying prescription drugs with significant price increases, and requiring pharmaceutical companies with high cost drugs to submit data on factors influencing cost are several such measures, and are included in the recently-passed House health care bill.

H.4639 also offers much-needed support to underpaid community hospitals in Massachusetts by reauthorizing the Community Hospital Reinvestment Trust Fund (CHRTF). The Fund, financed by an assessment on insurers and certain hospitals, will direct payments to community hospitals across the state facing financial challenges due to high numbers of Medicaid patients and reimbursement rates less than 90% of the statewide relative average price. Community health centers, which provide critical, cost effective care in the community, also receive additional funding in the bill. The bill also reauthorizes the Prevention & Wellness Trust Fund to promote community-based prevention programs, creates important disclosure requirements when out-of-network providers treat patients, and prohibits providers from balance billing consumers for surprise out-of-network costs.

“This bill takes a comprehensive approach to support high quality care in our communities, get to the bottom of rising costs, and shield consumers from those rising costs,” said Representative Barber. “I am pleased that so many of my priorities have been addressed in this bill, and I look forward to continuing my advocacy for these priorities as the bill moves forward this session.”

The House and Senate must now meet in conference committee to come to agreement on differences between H.4639 and the Senate’s comprehensive health care legislation, S.2211.

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