Bill
Bill > H1148
MA H1148
To prevent inappropriate denials by insurers for medically necessary services
summary
Introduced
03/29/2021
03/29/2021
In Committee
03/30/2022
03/30/2022
Crossed Over
Passed
Dead
12/31/2022
12/31/2022
Introduced Session
192nd General Court
Bill Summary
For legislation to prevent certain 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 amends existing law to require carriers (i.e., insurance companies) to pay for healthcare services ordered by the treating provider if the services are covered benefits and follow the carrier's clinical review criteria. The bill also sets limits on carriers' ability to recoup or adjust payments, and requires carriers to conduct a retrospective review and reverse a denial if a service is found to be medically necessary, even if the provider had only a partial authorization. Finally, the bill directs the Commissioner of Insurance to promulgate regulations to enforce these provisions within 90 days of the bill's effective date.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (1)
Last Action
Accompanied a study order, see H5222 (on 09/15/2022)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
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State Bill Page | https://malegislature.gov/Bills/192/H1148 |
Bill | https://malegislature.gov/Bills/192/H1148.pdf |
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