Massachusetts H4616 aims to improve the health insurance prior authorization process by standardizing requirements, reducing administrative burden.
Massachusetts H4616 seeks to enhance the health insurance prior authorization process by implementing standardized prior authorization processes, forms, and requirements across health insurance carriers. The bill mandates that carriers and utilization review organizations respond to prior authorization requests within 24 hours and prohibits retrospective denial of authorization for services already approved. It also requires carriers to cover treatments, services, or medications for at least 90 days upon enrollment if they were previously approved.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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