Bill > S551

This bill amends Section 12 of Chapter 176O of the General Laws to establish faster timelines for insurance carriers and utilization review organizations to make determinations on the medical necessity of proposed admissions, procedures, or services. Specifically, the bill requires carriers and utilization review organizations to make these determinations within 2 working days of obtaining all necessary information, and to notify the provider within 24 hours for approvals and 24 hours with written confirmation within 1 working day for adverse determinations. The bill also requires carriers and utilization review organizations to make concurrent review determinations within 1 working day and to continue providing the service until the insured is notified of an adverse determination.

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https://malegislature.gov/Bills/191/S551