BOSTON – Senator Michael O. Moore (D-Millbury) announced that the Massachusetts State Senate passed legislation to protect patients’ access to confidential health care. In an effort to maintain the confidentiality of patients covered as dependents on another person’s insurance policy, the “PATCH Act” requires insurance carriers to issue common summary of payment forms directly to the patient.
“This important piece of legislation protects patients from breaches in confidentiality, making it safer for them to access the care they need,” said Senator Moore. “I am proud to support the PATCH Act which sends a powerful message that everyone deserves access to confidential health care here in our Commonwealth.”
Some health insurers’ current billing and claims communication practices can unintentionally violate the basic right to privacy of a patient covered as a dependent on another person’s policy, for example a young adult, minor or spouse. Insurers routinely send summary of payment or Explanation of Benefits (EOB) forms, detailing the type and cost of medical services received, to the primary subscriber on an insurance plan. In many situations, young adults, minors or women may choose to forego certain types of treatment due to fears that a parent or spouse will see sensitive health information on an EOB form.
The bill requires the Division of Insurance to develop a common summary of payments form to be used by all insurance carriers in the Commonwealth. Insurers would be required to issue these forms at the member level and allow each insured member to choose their preferred method of receiving the forms.
The bill requires the Division of Insurance to define sensitive health care services that cannot be identified on the common summary of payments form. Instead, the EOB would provide generic information only, such as “office visit” or “medical care.” Patients who are legally authorized to consent to care would be allowed to request suppression of summary of payment forms for a specific service or procedure if no payment is due.
The bill also requires the Division of Insurance, in consultation with the Department of Public Health, to develop and implement a plan to educate providers and consumers regarding the rights of insured members and responsibilities of carriers to promote compliance.
The bill will now be sent to the House of Representatives for consideration. To continue tracking the legislation, S.2296, please visit the Legislature’s website by clicking below.