Massachusetts Division of Insurance Published Bulletin 2017-07

On Dec. 19, 2017, the Massachusetts Division of Insurance published Bulletin 2017-07, which relates to the definition of “sensitive health care services.” The new bulletin defines which services are considered “sensitive health care services” and explains that such services should not be identified specifically in carrier summary of payment (SOP) forms. The definition includes all of the following:

  1. Mental health services
  2. Substance use disorder services
  3. Gender transition-related services
  4. Testing, treatment and prevention of sexually transmitted diseases, HIV and AIDS (including pre-exposure prophylaxis (PrEP)
  5. Hepatits B and C testing, treatment and medication
  6. Reproductive and fertility services
  7. Contraceptive and abortion services
  8. Pregnancy testing and counseling
  9. Any visit that includes assessment of sexual risk, pregnancy intention and/or reproductive/sexual/pregnancy coercion
  10. Services related to sexual assault
  11. Domestic violence diagnosis, services, support and counseling
  12. Management of abnormal pap smears
  13. Diagnosis and treatment of vaginal infections
  14. Prenatal care

According to the bulletin, sensitive health care services may be related to any type of provider encounter, including (but not limited to) evaluation, screening, treatment, service, counseling, management and prescribed medications. Carriers are expected to take all necessary steps to ensure that by Feb. 1, 2018, sensitive health care services are excluded from those SOPs distributed to the plan sponsor and covered individuals.

The bulletin contains no new employer obligations, but employers should be aware of the information they (or others) may see in a carrier SOP form. Employers should work with carriers regarding any questions on SOP forms.

Bulletin 2017-07 »