Sensitive Health Care Services Definitions; Issued 12/19/2017

[LOGO] CHARLES D. BAKER GOVERNOR KARYN E. POLITO LIEUTENANT GOVERNOR COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation DIVISION OF INSURANCE 1000 Washington Street, Suite 810 • Boston, MA 02118-6200 (617) 521-7794 • Toll-free (877) 563-4467 http://www.mass.gov/doi JAY ASH SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT JOHN C. CHAPMAN UNDERSECRETARY OF CONSUMER AFFAIRS AND BUSINESS REGULATION GARY D. ANDERSON COMMISSIONER OF INSURANCE ## BULLETIN 2017-07 To: Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Inc., and Health Maintenance Organizations From: Gary Anderson, Commissioner of Insurance Date: December 19, 2017 Re: Sensitive Health Care Services Definition The Division of Insurance (“Division”) issues this bulletin to Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Inc., and Health Maintenance Organizations (hereinafter referred to as “Carriers”) to supplement Bulletin 2017-02 “Common Summary of Payments Format,” which requires the Division to define sensitive health care services through subsequent guidance. The Division defines the following list of health services as “sensitive health care services” for purposes of Summary of Payments forms (“SOPs”). These services are to be suppressed from being identified on all SOPs issued under Massachusetts General Laws Chapter 176O, §27: 1. Mental Health Services 2. Substance Use Disorder Services, including Medication and Treatment 3. Gender Transition-Related Services 4. Testing, Treatment and Prevention of Sexual Transmitted Infections (e.g., HPV vaccines) 5. Testing, Treatment and Prevention of HIV and AIDS (including pre-exposure prophylaxis (PrEP)) 6. Hepatitis C Testing, Treatment and Medication 7. Hepatitis B Testing, Treatment and Medication 8. Reproductive Services 9. Contraceptive Services 10. Fertility Services 11. Abortion Services 12. Pregnancy Testing and Counseling on Pregnancy Options 13. Any Visit Including Assessment of Sexual Risk, Pregnancy Intention, and/or Reproductive/Sexual/Pregnancy Coercion 14. Services Related to Sexual Assault 15. Domestic Violence Diagnosis, Services, Support and Counseling Bulletin 2017-07 December 19, 2017 Page 2 of 2 16. Management of Abnormal Pap Smears 17. Diagnosis and Treatment of Vaginal Infections 18. Prenatal Care The above sensitive health care services may be related to any type of provider encounter, including but not limited to, evaluation, screening, treatment/service, counseling, management and prescribed medications. The Division expects that Carriers will take all necessary steps to ensure that their internal processes and systems are modified to exclude the identification of the above sensitive health care services from those SOPs distributed to members pursuant to the requirements set forth in Bulletin 2017-02. In addition, the Division expects carriers to take steps that prohibit the identification of “sensitive services” within summary of payment forms by no later than February 1, 2018. If you have any questions about this bulletin, please contact Tracey McMillan, Director of Bureau Managed Care at 617-521-7347 or Tracey.T.McMillan@massmail.state.us.