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Early Intervention Mandate

The Massachusetts budget bill for fiscal year 2011, signed by Governor Patrick on June 30, 2010, includes an amendment to existing insurance mandates that prohibits health plans and insurers from charging a copayment, co-insurance, or deductible1 for medically necessary early intervention services furnished by an early intervention provider for an enrolled child from birth until his or her third birthday for plans that provide coverage for dependents.

Blue Cross Blue Shield of Massachusetts is in the process of updating the affected plans to remove all member copayments, co-insurance, and deductibles1 on medically necessary early intervention services provided on or after July 1, 2010. This change is being applied to all insured group, non-group, and administrative services contract (ASC) 32B plans, excluding: Medicare Advantage, Medex®', Medicare supplement plans, Managed Blue for SeniorsSM, Essential Blue Young Adult (YA), and the Federal Employee Program (FEP). We are in the process of updating Evidence of Coverage (EOC) packages to include language about the early intervention mandated change.

For ASC 32B accounts, the mandate will be applied effective July 1, 2010 in conjunction with fully insured business. For all other ASC accounts, we will apply this benefit change, beginning with October 1, 2010 renewal dates, unless the account declines the benefit. Please contact your account executive to discuss how you would like to proceed with the Massachusetts early intervention mandate.

If you have questions regarding this change, please contact your account executive.

1 For HSA-compliant plans, early intervention services will still be subject to the overall plan deductible, but not the copayment or co-insurance.

Blue Cross Blue Shield of Massachusetts

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