Massachusetts Bill

In 2003 a Bill was introduced in the Massachusetts legislature (S.B. 633) dealing with concierge medicine. The Bill was never adopted by the Senate, and no comparable Bill was introduced in the 2004 legislative term. The Bill has been re-introduced in the 2005 term, however, and it is so new I cannot find a Bill number. However, it is identical to Senate Bill 633.

The Bill has two parts. Section 1 deals with HMOs, and Section 2 deals with “preferred provider arrangements.” Section 1 provides that every “contract between an HMO and a participating provider shall contain a provision prohibiting the provider…from charging an access fee to members of the HMO.” Section 2 provides that “every preferred provider arrangement shall contain a provision prohibiting the provider…from charging an access fee” to a covered person.

“Access fee” is defined as a fee charged by the provider “as a condition of receiving covered services from the provider, regardless of whether such access is bundled with other membership privileges or amenities.” While the adoption of this Bill would not prevent a concierge physician from charging an access fee to patients that were not part of an HMO or PPO, it would spell the end of concierge practices that have a large number of HMO or PPO patients. It would not appear to affect non-PPO type insurance plans.