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Legal Memorandum: Affordable Health Care Insurance in MA

Issue: Under Massachusetts’ law and the ActProviding Access to Affordable, Quality, Accountable Health Care, 2006 Mass. Acts ch. 58 (the ‘Act’)and the corresponding regulations (114.5 Mass. Code Regs. 16.00, 17.00, 18.0 (proposed June 30, 2006; to be effective Oct. 1, 2006)), what rights will be provided for enforcement?

Area of Law: Employee Law, Government Programs and Benefits, Insurance Law
Keywords: Affordable health care insurance; Enforcement
Jurisdiction: Massachusetts
Cited Cases: None
Cited Statutes: 2006 Mass. Acts ch. 58,§ 6; 114.5 Mass. Code Regs. 16.00, 17.00, 18.0; Mass. Gen. Laws ch. 26, § 7A; 2006 Mass. Acts § 44; Mass. Gen. Laws, ch. 118G, § 18B; 2006 Mass. Acts ch. 58, § 46; Mass. Gen. Laws, ch. 149, § 6D ½; 2006 Mass. Acts ch. 58, § 34
Date: 08/01/2006

The Health Care Access Bureau plans to maintain a database of health benefit plan members.  The Bureau will require licensed carriers and the Medicaid Office to report on a monthly basis each Massachusetts resident for whom creditable coverage was provided during the previous month.  2006 Mass. Acts, ch. 58, § 6 (to be codified at Mass. Gen. Laws ch. 26, § 7A).

It will be unlawful for an employer to discriminate against an employee based on the employee’s receipt of free care, the employee’s reporting or disclosing his or her employer’s identity or other employer information, the employee’s completion of the Health Insurance Responsibility Disclosure form, or any circumstances relating to the free rider surcharge.  2006 Mass. Acts § 44 (to be codified at Mass. Gen. Laws, ch. 118G, § 18B).  Such discrimination constitutes a per se violation of ch. 93A.  Id.  Similarly, the employer may not penalize an employee based on the employee’s filing of an uncompensated care pool application or providing notice to the Division of Health Care Finance and Policy or a health care provider regarding the need for the employee’s health care services that causes the employer to be required to reimburse the pool.  2006 Mass. Acts ch. 58, § 46 (to be codified at Mass. Gen. Laws, ch. 149, § 6D ½). 

Under the Act, the Department of Labor, jointly with the Division of Health Care Finance and Policy must report, on or before July 1, 2007, to the Joint Committee on Health Care Financing and the House and Senate […]

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