Bill > S1146

This bill, amending Chapter 111 of the General Laws, requires hospitals in the Commonwealth to submit a written plan to the department within thirty days of their fiscal year start, aimed at eliminating the unnecessary duplication of diagnostic services, such as tests and imaging, when a patient has already undergone a similar procedure at another facility. This plan must detail current procedures for sharing test results with other hospitals or healthcare providers and outline strategies for improvement. The department has thirty days to approve or disapprove the plan, focusing on patient safety and cost reduction; if no action is taken, the plan is automatically approved. If a plan is disapproved, the hospital must submit a revised version within thirty days, and failure to comply or repeated disapproval may lead to an order for immediate submission, after which health insurance carriers may refuse payment for duplicate services unless the hospital proves medical necessity, and the hospital cannot bill the patient for those denied services.