Massachusetts House leaders plan to unveil legislation this week to help families navigate health care services and ensure that all children, including those in state custody, have access to services they need.
The legislation would require health insurance companies to maintain accurate lists of all the providers in their networks, and to update their online directories at least monthly.
Patients going through these lists often find old information that fails to reflect if a doctor has retired, moved out of network, or stopped accepting new patients. This is a particular problem for parents searching for mental health services for their children, House leaders said Monday.
“There’s nothing more frustrating than going through and trying to find the right provider for your child . . . and finding out they’re no longer accepting patients or they’ve moved offices,” said Representative Jennifer Benson, a Lunenburg Democrat who’s co-chairwoman of the Committee on Health Care Financing. “Making sure we have accurate, timely information is vitally important.”
The full Senate approved legislation last week that takes similar steps to require insurance companies to update their provider information.
House leaders described their bill to reporters Monday — though they had yet to file it. They plan to hold a vote as soon as this week, before heading on their August break.
“This bill reflects a commitment to child wellness,” said House Speaker Robert DeLeo, who also addressed the issue in a speech at the Greater Boston Chamber of Commerce in March.
The legislation would direct the state Health Policy Commission to study health care for children with complex medical conditions, including their access to medical services and the cost of their care.
It also calls for establishing three centers of excellence across the state that can serve as a clearinghouse for information on children’s mental health services.
And like many bills at the State House, it would establish new task forces and commissions. One of these new commissions would recommend strategies for increasing the pipeline of pediatric health care providers, while another would study ways to expand school-based health centers.
But a central focus of the legislation appears to be improving the provider information that insurance companies make available to patients and consumers.
Lora Pellegrini, chief executive of the Massachusetts Association of Health Plans, said she’s pleased the new bill will include compromise language — that insurers, hospitals, and advocates support — “to improve consumer-facing provider directories for all health plan members, including parents seeking services for their children.”
Health insurers are already working together on a new online system where providers can update their information and send it to several insurers at once.
Boston Children’s Hospital, the state’s largest pediatric health care provider, also supports the House legislation and helped work on the section about children with complex conditions.
“We know first-hand the significant and far-reaching impact this legislation will have,” Josh Greenberg, the hospital’s vice president of government relations, said in a statement.
The bill includes a section that would provide automatic enrollment in MassHealth, the state Medicaid program, for children aging out of foster care. Federal rules already stipulate that this population is covered until they are 26 years old, but advocates say those leaving foster care often experience such upheaval, they get lost in the shuffle.
“Enrolling in MassHealth annually is hard enough for adults to handle, but it is a huge undertaking for many youth who are struggling just to find a place to sleep nightly,” Tammy Mello, executive director Children’s League of Massachusetts, said in a statement.
The bill would also require the Department of Children and Families, which administers the state’s foster care program, to issue a report to the Legislature by Oct. 15 about steps it is taking to improve access to foster care and reform the system. Foster families have complained that the state’s chaotic system fails to supply them with vital medical information or sufficient psychological support for kids who badly need it.
In the report, DCF will be required to explain its efforts to provide timely information-sharing with foster families, including children’s medical histories and families’ access to mental health support.
Finally, the department is required to explain how it is tracking and surveying foster families, including those who leave the system, often out of frustration over a lack of information from DCF.