Sen. Sal DiDomenico (D-Everett) and his colleagues in the Massachusetts Senate recently 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.
“Every patient deserves the right to accessible health care that is both safe and confidential,” said Sen. DiDomenico, Vice Chairman of the Senate Committee on Ways & Means and a co-sponsor of the bill. “No one should have to worry that their personal and sensitive health care decisions will be shared with anyone other than their doctor, and I am proud to support this bill that will ensure every patients’ basic right to privacy is protected.”
“The PATCH Act ensures that every Massachusetts resident retains their fundamental right to privacy when making health care decisions,” said Senate President Harriette L. Chandler (D-Worcester). “A patient is entitled to confidentiality whether or not they are the primary subscriber. I am very pleased that the Senate has passed this legislation.”
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.