Bill
Bill > S688
MA S688
To prevent inappropriate denials by insurers for medically necessary services
summary
Introduced
03/29/2021
03/29/2021
In Committee
02/17/2022
02/17/2022
Crossed Over
Passed
Dead
12/31/2022
12/31/2022
Introduced Session
192nd General Court
Bill Summary
For legislation to prevent inappropriate denials by insurers for medically necessary services. Financial Services.
AI Summary
This bill aims to prevent inappropriate denials by insurers for medically necessary services. It would require insurers to pay for healthcare services ordered by the treating provider if the services are a covered benefit and follow the insurer's clinical review criteria. The bill also limits insurers' ability to deny claims or recoup payments due to administrative or technical defects, and requires them to conduct retrospective reviews if a claim is denied due to lack of authorization. The bill directs the Commissioner of Insurance to promulgate regulations to enforce these provisions within 90 days, which would apply to provider contracts entered into, renewed, or amended after the effective date of the regulations.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (1)
Last Action
Accompanied a study order, see S2917 (on 06/09/2022)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://malegislature.gov/Bills/192/S688 |
| Bill | https://malegislature.gov/Bills/192/S688.pdf |
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