The bill amends Chapters 27-18, 27-19, and 27-20 of the General Laws to establish a new section titled "Equal pay for healthcare providers." This legislation mandates that whenever a health insurance policy covers services within the lawful scope of practice of licensed nurse practitioners, including prescribing drugs and providing primary care or mental health services, the insured is entitled to reimbursement for those services regardless of whether they are performed by a licensed physician or a nurse practitioner. The bill specifies that reimbursements for services provided by licensed physician assistants or certified nurse practitioners in independent practice must match the reimbursement amount paid to licensed physicians for the same services in the area.
Additionally, the bill clarifies that "independent practice" refers to healthcare services billed under the name and national provider identifier of the nurse practitioner or physician assistant. It also states that this section does not apply to federally qualified group practice health maintenance organizations or insurers that do not compensate practitioners on a fee-for-service basis. Importantly, insurers are prohibited from reducing the reimbursement paid to licensed physicians to comply with this new requirement. The act is set to take effect on January 1, 2026.