An Act streamlining the prior authorization process
By Mr. Cronin, a petition (accompanied by bill, Senate, No. 706) of John J. Cronin for legislation to streamline the prior authorization process for covered health care services. Financial Services.
This bill requires the creation of a list of medical services eligible for automated real-time approvals of prior authorization requests. The commissioner of insurance will develop this list, using input from the Massachusetts Collaborative and other stakeholders, by focusing on services that typically receive high approval rates and have well-established clinical treatment protocols. The finalized list must be published by the Division of Insurance by January 1, 2027. Following this, insurance carriers who require prior authorization for these listed services must have an automated approval system in place by January 1, 2028, to facilitate cases that clearly meet medical necessity criteria.
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