This bill amends various chapters of the General Laws related to health insurance policies, specifically focusing on ensuring equal reimbursement for healthcare services provided by licensed nurse practitioners, physician assistants, and physicians. It introduces a new section, titled "Equal pay for healthcare providers," which mandates that whenever a health insurance policy covers a service within the lawful scope of practice of a nurse practitioner or physician assistant, the insured is entitled to reimbursement for that service regardless of whether it is performed by a physician or a licensed nurse practitioner.
The bill stipulates that reimbursement for services provided by nurse practitioners or physician assistants in independent practice must be equal to that of a licensed physician performing the same service. It defines "independent practice" as the provision of healthcare services in a setting where the licensed physician assistant or certified nurse practitioner bills insurers for services using their own name and national provider identifier.
Additionally, the bill outlines exceptions for certain group practice health maintenance organizations and insurers that do not compensate practitioners on a fee-for-service basis. It also prohibits insurers from reducing the reimbursement paid to licensed physicians in order to comply with this new requirement. The provisions of this act are set to take effect on January 1, 2026.