(6) DHPA Toolkit - State Regulation of PBMs.pdf

Medical Society Releases Practice Guide on New State and Federal Price Transparency Requirements

The Massachusetts Medical Society is pleased to share a comprehensive practice guide developed by the MMS to support physician practices navigating new state and federal price and transparency disclosure requirements related to surprise billing. 

 

These new, overlapping disclosure requirements on physicians related to notice and price transparency have created significant challenges for physicians seeking to comply in good faith with both laws. While the implementation of the state requirements has been delayed, some version of these state requirements is likely to take effect on July 31, 2022. Most of the federal requirements are currently in effect, as of January 1, 2022. As such, this resource is intended to help physician practices prepare to understand whether and how both the state and federal disclosure requirements may apply for any given patient and to provide considerations for operationalizing these new requirements.

 

For more information, please visit the Medical Society’s Surprise Billing and Patient Notice Resource Center.

Baker-Polito Health Care Legislation Overview_ March 2022 (002).pdf

There are important changes ahead which may impact endoscopic practice and patient access to care in both private and academic centers. This article provides a nice review. 

MGA remains committed to representing gastroenterologists and our patients in Massachusetts.

Sincerely,
The MGA Board

In response to the Blue Cross Blue Shield "site of service differential," and specifically, the June 1, 2013 notice of further reduction in reimbursement for endoscopic procedures performed in hospitals, we took the following actions:

1. Retained the counsel of attorney Michael Blau, Esq from Foley and Lardner, LLP.
2. Solicited the input of our national GI societies.
3. Filed a formal complaint (93A Demand for Relief August 27,2013) with the Massachusetts Commissioner of Insurance, the Massachusetts Attorney General, and the State Bureau of Consumer Affairs.

The MGA believes this policy is unfair and unsafe for patients and consumers by limiting necessary hospital services and intruding inappropriately on the patient-provider relationship. We believe it violates Massachusetts law by flouting anti-kickback statutes, and restricting treatment for patients without adequate education of consumers and without approval from the appropriate state officials.

We await a response and will keep you informed.

Sincerely,
The MGA Board