Mass. Gen. Laws ch. 6A, sec. 16D — MA Code / Part I / Title II / Chapter 6A / Section 16D
Managed care oversight board; advisory committee
Status: in_force

Section 16D. (a) The managed care oversight board is hereby established within, but not subject to the control of, the executive office of health and human services. The board shall consist of the following members: the secretary of said office, the commissioner of insurance, the commissioner of public health, the commissioner of the department of mental health, the commissioner of medical assistance, the executive director of the group insurance commission, the director of consumer affairs and business regulation, a physician member of the board of registration in medicine to be appointed by the governor, and the secretary of administration and finance. The board shall be chaired by the secretary of health and human services. Each such member may appoint a designee to serve in the member's place. (b) The board shall appoint an executive director to oversee and coordinate the activities of the board. The board shall be assisted in its duties by the office, which shall provide technical, technological, operational and administrative support. The expenses of the board shall be funded from amounts appropriated from the general fund or any other fiscal resource of the commonwealth designated for such purpose. (c) The board shall have oversight authority over the office of patient protection within the health policy commission established by section 16 of chapter 6D, and the managed care bureau in the division of insurance established by section 2 of chapter 176O, but the board's authority in this regard shall be limited to coordinating functions between said office and said bureau and reviewing and commenting upon regulations promulgated by said office and said bureau. The board shall not have authority to approve or disapprove such regulations except to the extent of a conflict between the regulations promulgated or proposed or any actions undertaken by said office and said bureau. The board shall take all necessary steps to coordinate the functions of said office and said bureau in order to avoid, to the maximum extent possible, redundancy and duplication of effort. (d) There is hereby established an advisory committee to advise the board on issues relating to managed care practices including, but not limited to, issues involving health care cost, quality and access. Said committee shall also have the right to review and comment upon all rules, regulations and guidelines issued by the office of patient protection and the managed care bureau at least 60 days before the date such regulations become final, but in the case of emergency regulations the time period shall be a reasonable time under the circumstances as determined by the secretary of health and human services. Said committee shall designate one person to serve as a liaison to the managed care oversight board. The committee shall consist of one person who shall represent Health Care for All; one person who shall represent the Massachusetts Medical Society; one person who shall represent the Massachusetts Association of Health Maintenance Organizations; one person who shall represent Blue Cross Blue Shield of Massachusetts, one person who shall represent the Associated Industries of Massachusetts; one person who shall represent the Massachusetts Nurses Association; one person who shall represent the Massachusetts Hospital Association; one person who shall represent the Ad Hoc Committee to Defend Health Care; and seven members to be appointed by the board, one of whom shall represent a mental health consumer advocacy organization; one of whom shall represent a senior citizen organization; one of whom shall represent an organization representing the disabled and chronically ill; one of whom shall represent community health centers; one of whom shall represent the Massachusetts Healthcare purchaser group; one of whom shall represent the Life Insurance Association of Massachusetts; and one of whom shall represent a utilization review organization not otherwise represented. Said committee shall elect a chair from among its members and adopt bylaws for its proceedings.

Section 16D. (a) The managed care oversight board is hereby established within, but not subject to the control of, the executive office of health and human services. The board shall consist of the following members: the secretary of said office, the commissioner of insurance, the commissioner of public health, the commissioner of the department of mental health, the commissioner of medical assistance, the executive director of the group insurance commission, the director of consumer affairs and business regulation, a physician member of the board of registration in medicine to be appointed by the governor, and the secretary of administration and finance. The board shall be chaired by the secretary of health and human services. Each such member may appoint a designee to serve in the member's place.

(b) The board shall appoint an executive director to oversee and coordinate the activities of the board. The board shall be assisted in its duties by the office, which shall provide technical, technological, operational and administrative support. The expenses of the board shall be funded from amounts appropriated from the general fund or any other fiscal resource of the commonwealth designated for such purpose.

(c) The board shall have oversight authority over the office of patient protection within the health policy commission established by section 16 of chapter 6D, and the managed care bureau in the division of insurance established by section 2 of chapter 176O, but the board's authority in this regard shall be limited to coordinating functions between said office and said bureau and reviewing and commenting upon regulations promulgated by said office and said bureau. The board shall not have authority to approve or disapprove such regulations except to the extent of a conflict between the regulations promulgated or proposed or any actions undertaken by said office and said bureau. The board shall take all necessary steps to coordinate the functions of said office and said bureau in order to avoid, to the maximum extent possible, redundancy and duplication of effort.

(d) There is hereby established an advisory committee to advise the board on issues relating to managed care practices including, but not limited to, issues involving health care cost, quality and access. Said committee shall also have the right to review and comment upon all rules, regulations and guidelines issued by the office of patient protection and the managed care bureau at least 60 days before the date such regulations become final, but in the case of emergency regulations the time period shall be a reasonable time under the circumstances as determined by the secretary of health and human services. Said committee shall designate one person to serve as a liaison to the managed care oversight board. The committee shall consist of one person who shall represent Health Care for All; one person who shall represent the Massachusetts Medical Society; one person who shall represent the Massachusetts Association of Health Maintenance Organizations; one person who shall represent Blue Cross Blue Shield of Massachusetts, one person who shall represent the Associated Industries of Massachusetts; one person who shall represent the Massachusetts Nurses Association; one person who shall represent the Massachusetts Hospital Association; one person who shall represent the Ad Hoc Committee to Defend Health Care; and seven members to be appointed by the board, one of whom shall represent a mental health consumer advocacy organization; one of whom shall represent a senior citizen organization; one of whom shall represent an organization representing the disabled and chronically ill; one of whom shall represent community health centers; one of whom shall represent the Massachusetts Healthcare purchaser group; one of whom shall represent the Life Insurance Association of Massachusetts; and one of whom shall represent a utilization review organization not otherwise represented. Said committee shall elect a chair from among its members and adopt bylaws for its proceedings.