In 1996, then Governor William Weld followed the lead of Senator Marian Walsh (D-West Roxbury) and the legislative leadership by signing Chapter 80 into law over the objections of the medical community. At that time, Walsh was the Senate chairman of the Joint Committee on Public Service. She was the driving force behind the legislation.

“Five years ago this issue had reached a crisis level with our members. The GIC was trying to control costs, but the doctors were not budging,” recalls Association Legislative Liaison Shawn Duhamel. “Instead of negotiating with the GIC, the medical providers were simply billing our members for the balance. Chapter 80 not only stopped that practice, but has also given the GIC a way of controlling costs.”

On July 1, 1998 the GIC, through Indemnity Plan Administrator UniCare, implemented the MBRS system. Under the MBRS, UniCare determines the market price of services rendered to GIC members.

By implementing MBRS, the GIC was able to gain some control over the increasing cost of medical claims. According to UniCare, many medical providers were charging GIC members higher prices than were charged to other plans for the same service.

Due to Chapter 80, hospitals and doctors within Massachusetts must accept payment from the GIC as payment in full. Therefore, UniCare was able to dictate the fair reimbursement rate without members being billed the balance.

“This program has certainly proven to be successful. Saving tens of millions of dollars not only helps the state, but also keeps our members’ premiums down,” says Duhamel. “Hospitals and doctors had long viewed the Indemnity Plan as a blank check. That practice had to end.”