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Massachusetts Health Law: Update 2008 Mental Health Parity Coverage Expanded In 2000, the legislature passed a law requiring insurance policies issued in Massachusetts to cover mental illnesses on a par with physical illnesses. Nine “biologically- based” mental disorders, including schizophrenia, major depressive disorder and bipolar disorder, were entitled to parity. Chapter 256 of the Acts of 2008 requires insurers to provide parity coverage of four additional diagnoses beginning July 1, 2009: eating disorders, post-traumatic stress disorder, substance and alcohol abuse, and autism. See Division of Insurance Bulletin 2009-4. The protections under the 2000 law otherwise remain unchanged.  Click here to learn more about the provisions of the original parity law.   Coverage Standards Set for Individual Mandate As of January 1, 2009, adult residents of Massachusetts must have health insurance that provides “minimum creditable coverage” (MCC). According to regulation, plans that offer MCC must cover defined “core services” and “medical benefits,” and limit cost-sharing (such as co-payments and deductibles) to specific levels. A health benefit plan may be combined with other health benefit plans to comply with MCC rules. Also, for 2009, a federally-recognized high deductible health plan (HDHP) will be deemed to provide MCC. Per Division of Insurance guidance, health insurers must disclose on the face of a policy or plan whether it offers minimum creditable coverage.  MassHealth Benefits  for Same-Sex Spouses Federal Medicaid regulators have interpreted the 1996 Defense of Marriage Act (DOMA) to preclude payment of federal funds for Medicaid benefits extended to same-sex spouses. Chapter 217 of the Acts of 2008 added section 61 to General Laws chapter 118E to declare, effective October 29, 2008: Notwithstanding the unavailability of federal financial participation, no person who is recognized as a spouse under the laws of the commonwealth shall be denied benefits that are otherwise available under this chapter due to the provisions of 1 U.S.C. § 7 or any other federal non-recognition of spouses of the same sex. Rights of Nursing Home Residents on Medicaid  Chapter 251 of the Acts of 2008 amended section 70E of General Laws chapter 111 effective November 3, 2008 to provide enhanced rights for Medicaid beneficiaries faced with involuntary discharge or transfer from a nursing facility.  The amended portion of the law provides: A resident, who requests a hearing pursuant to section 48 of chapter 118E, shall not be discharged or transferred from a nursing facility licensed under section 71 of this chapter, unless a referee determines that the nursing facility has provided sufficient preparation and orientation to the resident to ensure safe and orderly transfer or discharge from the facility to another safe and appropriate place. Greater Coverage of Low-Protein Food Products Chapter 214 of the Acts of 2008 increased the amount of coverage Massachusetts insurers must offer for nonprescription enteral formulas - food products modified to be low protein for individuals with inherited diseases of amino acids and organic acids. Effective October 28, 2008, the mandated annual benefit for these products increased from $2,500 to $5,000.  Eligibility of children for parent's coverage  The 2006 Health Reform Law broadened dependent coverage offered by insurers. As a result of clarifying amendments in 2007, insurers must make dependent coverage available to persons “under 26 years of age or for 2 years after the end of the calendar year in which such persons last qualified as dependents under 26 U.S.C. 106, whichever occurs first.” Per Division of Insurance guidance, insurers must consider a child a dependent under the parent’s health policy (up to a maximum age of 26), as long as he receives half his support from the parent. Whether the child is claimed on the parents’ tax return has no bearing on eligibility for coverage.