MA H4338

Insurance carriers are prohibited from reducing negotiated payment rates for evaluation and management or procedural services solely because a provider billed other health care services (including minor surgery) on the same day

Any provider agreement provisions allowing same-day service payment reductions are rendered void

For self-funded health plans where carriers only provide administrative services, carrier obligations are limited to recommending coverage authorization to the third-party payor

Amends Section 16 of Chapter 176O of the Massachusetts General Laws