This bill aims to enhance access to patient care by ensuring equitable reimbursement for services provided by both physicians and certified registered nurse anesthetists (CRNAs) in Massachusetts. It amends various chapters of the General Laws to prohibit distinctions in participation, coverage, and payment between these two groups when they are acting within the scope of their licensure and certification. Specifically, the bill mandates that reimbursement rates for CRNAs must be at least equal to those for physicians for the same services, and it prevents reductions in physician reimbursement rates to comply with this requirement. Additionally, the bill requires that claims for payment must include the National Provider Identifier of the provider who delivered the service.

The legislation also introduces new definitions for CRNAs and establishes that any contracts related to health insurance, Medicaid, or other health plans must adhere to these equitable reimbursement standards. It allows for varying reimbursement rates based on quality or performance measures, provided these measures are consistent for both physicians and CRNAs. Furthermore, the bill empowers the commissioner of insurance to create rules and regulations for its implementation and enforcement, thereby ensuring that the provisions are effectively carried out.

Statutes affected:
Bill Text: 118E-6, 176B-1, 176G-1