MA H1383

Health Policy Commission must conduct an analysis on prior authorization for health care services, in collaboration with the Center for Health Information and Analysis and Division of Insurance

Report must inventory all admissions, services, treatments, procedures, and medications requiring prior authorization, including approval/denial rates for both standard and expedited requests

Analysis must assess total health care expenditures for processing prior authorization requests and appeals, and examine impact on patient access by demographics, geographic region, and service type

Report must evaluate "gold-carding" waiver programs and integration of standardized electronic prior authorization into electronic health records

Final report with legislative recommendations due to Joint Committee on Health Care Financing and Ways and Means committees within 1 year of the act's effective date