Bill
H 1149
Mass. H.1149 requires dental plans (GIC and private insurers) to cover cone-beam CT scans, defines CBCT, and conditions carrier approval on including CBCT coverage.
Status and Procedural Details
- Introduced: February 27, 2025
- Hearing: Scheduled October 27, 2025, 10:30 AM – 4:00 PM, Gardner Auditorium
- Referred to: Committee on Financial Services (2/27/2025)
- Related bill: HD 613 (replaces)
- Legislative actions note: Senate concurrence listed in the bill’s action log
Purpose and Intent
- The bill requires broader coverage for cone beam computed tomography (CBCT) scans within Massachusetts dental benefits. It aims to ensure that CBCT imaging—an advanced dental imaging modality—is included in the coverage offered by public and private dental benefit plans in the Commonwealth and for Commonwealth employees.
Key Provisions (by section)
- Section 1 (Chapter 32A, new Section 35): For dental benefit plans offered by the Commonwealth’s Group Insurance Commission to active or retired employees, coverage must include CBCT scans as defined in Chapter 176X.
- Section 2 (Chapter 118E, new Section 87): The Division of Insurance and any contracted insurers providing dental benefit plans must include CBCT coverage.
- Section 3 (Chapter 176X, amended Section 2): The Commissioner may approve only those carriers offering dental benefit plans that include CBCT coverage (carriers licensed under chapters 175, 176B, 176E, 176G, or 176I are affected).
- Section 4 (Chapter 176X, new Section 5): Defines CBCT and mandates that any dental benefit plan within the Commonwealth must provide coverage for CBCT scans.
- Section 4 (Definitions): CBCT is defined as a medical imaging device using X-ray tomography with a cone-shaped X-ray beam.
What Would Change and Who Is Affected
- Coverage expansion: CBCT scans would become a required covered service in:
- Dental benefit plans offered to active and retired Commonwealth employees through the Group Insurance Commission (GIC).
- All dental benefit plans regulated by the Division of Insurance and offered by contracted insurers to residents of the Commonwealth.
- Carriers and plan approvals: The state’s insurance regulator would condition approval of carriers on including CBCT coverage, potentially restricting plan options to those that cover CBCT (subject to the specified licensing chapters).
- Definitions: Establishes a standardized CBCT definition for purposes of coverage.
Potential Impacts and Considerations
- Access and utilization: Likely broader access to CBCT imaging for dental patients, with potential improvements in diagnostic capability and treatment planning.
- Costs and premiums: Insurers may incur higher claim costs due to mandated CBCT coverage; potential downstream effects on premiums, cost-sharing, or plan design not specified in the bill.
- Implementation: Requires alignment across the GIC, the Division of Insurance, and private insurers to ensure consistent CBCT coverage across plans.
- Effective date: The bill text does not specify a separate effective date; coverage changes would typically take effect upon enactment or as determined by the act’s provisions.
Definition of CBCT
- Cone beam computed tomography (CBCT): A medical imaging device using X-ray tomography with a cone-shaped X-ray beam to capture imaging data.
Compiled from official sources — confirm details with the bill’s official record.
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