HOUSE DOCKET, NO. 00269 FILED ON: 01/13/2011
HOUSE . . . . . . . . . . . . . . . No. 00279
The Commonwealth of Massachusetts
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PRESENTED BY:
Michael A. Costello
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled:
The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying bill:
An Act to enable the formation of accountable care organizations..
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PETITION OF:
N
AME
:D
ISTRICT
/A
DDRESS
:
Michael A. Costello1st Essex Robert L. HedlundPlymouth and Norfolk Thomas P. KennedySecond Plymouth and Bristol
HOUSE . . . . . . . . . . . . . . . No. 00279
By Mr. Costello of Newburyport, petition (accompanied by Bill, House, No. 00279) of Michael A.Costello and Thomas Kennedy for legislation to enable the formation by individual health care providers of accountable care organizations. Joint Committee on Financial Services.
The Commonwealth of Massachusetts
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In the Year Two Thousand Eleven
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An Act to enable the formation of accountable care organizations.
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Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authorityof the same, as follows:
1SECTION 1.2Chapter 111 of the General Laws, as appearing in the 2008 Official Edition, is hereby amended3by inserting at the end of section 204 the following :4(f) The provisions of this section shall apply to any committee formed by an individual health5care provider, physician group practice, licensed health care facility or any combination thereof 6to perform the duties or functions of medical peer review as set forth in section one of this7chapter, notwithstanding the fact that the formation of the committee is not required by law or 8regulation or that the individual, group or facility is not solely affiliated with a public hospital or 9licensed hospital or nursing home or health maintenance organization.10Section 2.
11The General Laws are hereby amended by inserting after chapter 93H the following chapter:12CHAPTER 93I13PROVIDER JOINT NEGOTIATIONS14Section 1. As used in this chapter, the following words shall have the following meanings:15“Attorney General,” the attorney general of the commonwealth and individuals designated by16him to act on his behalf in carrying out the purposes of this chapter.17“Carrier,” an insurer licensed or otherwise authorized to transact accident or health insurance18under chapter 175; a nonprofit hospital service corporation organized under chapter 176A; a19nonprofit medical service corporation organized under chapter 176B; a health maintenance20organization organized under chapter 176G; and an organization entering into a preferred21provider arrangement under chapter 176I. A third party administrator shall be considered a22carrier when interacting with health care professionals.23“Carrier affiliate,” a carrier that is affiliated with another entity by either the insurer or entity24having a five percent or greater, direct or indirect, ownership or investment interest in the other 25through equity, debt or other means.26“Covered lives,” the total number of individuals who are entitled to benefits under a health care27insurance plan, including, but not limited to, beneficiaries, subscribers and members of the plan.28“Health care professional,” a physician or other health care practitioner licensed, accredited or 29certified to perform specific health services consistent with law, person, acting alone or acting30with other persons through a partnership, professional corporation, organization or association.
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