Overview
Under Massachusetts General Law, CHIA reviews health benefit mandate bills as requested by Massachusetts legislative committees. These prospective mandated benefit reviews (MBRs) look at how well a service works (medical effectiveness) and how coverage may affect health insurance costs. CHIA also reviews all existing mandates (retrospective MBRs) every 4 years.
Prospective MBRs
Retrospective MBRs
Benefit Mandate Requirements
Additional Information
Health benefit mandates are state laws that require state-licensed health insurance plans to cover certain services; all states have these laws. Some cover common services, like emergency care or diabetes supplies, while others cover less common services, like in vitro fertilization or applied behavioral treatment for autism.
While mandates can make health care coverage more complete, they can also increase costs. Because of this, 29 states, including Massachusetts, have a systematic process to study both the benefits and the costs of these bills and laws.
These reviews help balance two goals: making sure people have enough coverage and keeping health care affordable. Federal law, including the Affordable Care Act (ACA), may also affect what mandates are proposed or passed in Massachusetts. By studying both the medical value and the cost of proposed mandates, CHIA gives policymakers and other stakeholders clear, unbiased information.
Recommended Links
Health Care Settings & Providers
Analysis and reports on health care clinicians and the places care services are delivered, including hospital profiles, nursing facilities, primary care, behavioral health services, and Case Mix reporting.
CHIA Regulations (CMR)
Access CHIA's regulations governing health care data collection and reporting in Massachusetts, including current rules, administrative bulletins, and hearings.