Bill > S706

This bill aims to streamline the prior authorization process in healthcare by requiring the Massachusetts insurance commissioner to develop a list of medical services that can be automatically approved in real-time when providers electronically submit clinical information that clearly demonstrates a patient meets medical necessity criteria. The commissioner will collaborate with the Massachusetts Collaborative and other stakeholders to create this list, focusing on services with historically high prior authorization approval rates and well-established clinical treatment protocols. By January 1, 2027, the Division of Insurance must publish this list on its website, and by January 1, 2028, insurance carriers must implement an automated system for instantly approving these specified services when the medical necessity is unambiguously demonstrated. The goal is to reduce administrative burden, speed up patient access to needed medical services, and create a more efficient healthcare approval process.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S706