January 09, 2018
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:
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 »