There are two laws on the books on which some insurers and providers still need clarity, and the state's Division of Insurance wants to clear up any confusion.
Patients in Massachusetts can get birth control in Massachusetts without co-pays. And instead of mandating that a patient go to the pharmacy every month to get a birth control prescription refilled, Massachusetts law says insurers must cover a 12-month supply at one time after an initial three-month prescription. That 2017 law and the Division of Insurance (DOI)
implementation regulations were pretty much unknown until a series of good journalism reports this year called attention to it.
DOI then held a series of webinars for clinicians and pharmacists to inform them of the law's details. Last week, DOI decided to go even further; it says it wants to produce additional guidance, including a potential question-and-answer document to increase understanding of the benefit.
DOI will hold virtual meetings (details still to be decided but which will be posted on its website) at 1 p.m., on Friday, October 15, Friday, October 29, and Friday, November 12 to discuss the issue. Any provider, consumer, or insurer that has thoughts about what to discuss in the sessions, should contact Kevin Beagan, DOI deputy commissioner of the Health Care Access Bureau, at
kevin.beagan@mass.gov.
On September 9, 2021, DOI issued
Bulletin 2021-11 regarding prohibited discrimination within health coverage for gender affirming care. Health insurers cannot categorically exclude services used in the treatment of gender dysphoria when those services are medically necessary or when the same services are covered for the treatment of other conditions.
Now, DOI wants to answer questions on the issue and determine if further regulations or explanations are required. As in above, DOI is setting aside three 1 p.m. discussions on Friday October 8, 22, and November 5, with video platform details to come. Send thoughts/inquires to DOI's Beagan at
kevin.beagan@mass.gov.