Bill > H1118

This bill requires health insurance plans to maintain adequate staffing during evenings, weekends, and holidays to process prior authorization requests within 24 hours of receipt. A prior authorization request is a submission by a healthcare provider to a patient's health insurance plan seeking approval for a service or benefit that the treating healthcare provider considers medically necessary. By mandating timely review and response to these requests during non-standard business hours, the bill aims to improve the efficiency and responsiveness of health insurance plan administrative processes. The requirement applies to all health insurance plans as defined in Section 1 of Chapter 6D, which suggests it is specifically targeting health plans operating within the state of Massachusetts. The bill seeks to reduce potential delays in patient care that can occur when prior authorization requests are not promptly reviewed, particularly during times when staffing might traditionally be reduced.

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https://malegislature.gov/Bills/194/H1118