Bill > S637

This bill aims to improve the health insurance prior authorization process. It requires student health insurance plans, the Group Insurance Commission, and health insurance carriers to adopt utilization review criteria that are scientifically derived and evidence-based, and to make these criteria easily accessible to the public. The bill also prohibits retrospective denial of authorization for services that were previously approved, unless the approval was based on inaccurate information or the services were not provided as approved. Additionally, the bill establishes a committee to develop recommendations for simplifying prior authorization standards and processes, and requires the Health Policy Commission to analyze the progress of adopting statewide forms and standards for electronic prior authorization.

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https://malegislature.gov/Bills/192/S637