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 and clarifications regarding CRNAs and their role in healthcare, ensuring they are recognized as equal providers in the healthcare system. It includes provisions for various health insurance policies and plans, including Medicaid-managed care organizations and health maintenance organizations, to align with these equitable reimbursement practices. The bill emphasizes that while varying reimbursement rates based on quality or performance measures can be established, such measures must be consistent for both physicians and CRNAs. Overall, the bill seeks to promote fairness in healthcare reimbursement and improve patient access to care.

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