H4616

Improving the health insurance prior authorization process

Introduced·10/20/25
Introduced Text

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.

Included in complete analysis

  • Overview
  • Core Provisions
  • Implementation
  • Impact
  • Legal Framework
  • Critical Issues

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Where it stands

Current
Ways and Means Committee
Next
Committee decision

Sponsors

0
0
Democratic CaucusRepublican Caucus

History

Jul 29

House

Committee recommended bill ought to pass and referred to the committee on House Ways and Means

Jun 17

House

Reporting date extended to Friday, July 31, 2026

Mar 19

House

Reporting date extended to Monday, June 15, 2026