INCREASE ACCESS TO HEALTH CARE

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By Bob Katzen

The Senate 38-0, approved and sent to the House a bill sponsors say will increase access to health care, protect patients and enhance quality care. The measure requires insurance carriers, including MassHealth, to cover telehealth services in any case where the same in-person service would be covered and requires reimbursement rates to match in-person services over the next two years. It also eliminates “surprise billing,” the much-criticized practice of charging unsuspecting patients who received health care services outside of their insurance plan’s network for costs that insurers refuse to pay.

Other provisions would allow registered nurse practitioners, nurse anesthetists and psychiatric nurse mental health specialists who meet specific education and training standards to practice independently; recognize pharmacists as health care providers, enabling them to integrate more fully into coordinated care teams; and create a new professional license for “dental therapists,” who will be authorized to provide dental hygiene and other oral health services. Supporters note that this will help expand access to dental care in underserved communities.

“The [bill] ensures that our healthcare system can continue to deliver quality, affordable and accessible care long after the COVID-19 state of emergency has ended,” said Sen. Cindy Friedman (D-Arlington), Senate chair of the Committee on Health Care Financing. “By increasing access to telehealth services, eliminating the unfair practice of surprise billing and expanding our healthcare workforce, we are taking important steps to protect patients and increase access to quality care for all.”

“When it comes to making telehealth services permanently accessible, ending surprise billing and expanding scope of practice, let me be clear: we cannot wait,” said Senate President Karen Spilka (D-Ashland). “We have learned a lot about how to deliver accessible health care during the global pandemic, and we can and should implement these changes now.”

“It is vital that we deliver accessible and equitable healthcare to people across the commonwealth,” said Sen. Eric Lesser (D-Longmeadow). “The coronavirus pandemic has revealed inequities and inadequacies in our current healthcare system, and it is important that we continue to legislate comprehensive healthcare reforms to protect patients and providers in the face of these unprecedented challenges.”

Although no senators voted against the bill, some small businesses and health insurance companies have expressed some concerns that it goes too far. “We believe requiring plans to pay telehealth at an in-person rate for two years is too long, and we recommend a shorter time frame for the sunset of payment parity such as 90 days after rescission of the governor’s executive order mandating telehealth,” said the leaders of Retailers Association of Massachusetts, Massachusetts Association of Health Plans and the state chapter of the National Federal of Independent Business.

They suggested that a transition period tied to the end of the COVID pandemic would allow for payers and providers to negotiate appropriate reimbursement for certain health care services that may not represent a comprehensive in-person consultation between a member and a provider. They also argued that currently contracted rates between providers and insurers for telehealth services cannot be circumvented by statute.

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