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MA S1403

Bill

Status

Introduced

2/27/2025

Primary Sponsor

Cindy Friedman

Click for details

Origin

Senate

194th General Court

AI Summary

  • Requires health insurance carriers to publish searchable lists of all items, services, and medications requiring prior authorization on their websites, and prohibits prior authorization requests for unlisted items
  • Mandates carriers report annual data on prior authorization approvals, denials, and processing times to the Division of Insurance by July 1, with public disclosure by December 1
  • Prohibits retrospective denial of previously authorized services, limits payment recoupment to 1 year, and requires preauthorization approvals to remain valid for the duration of treatment or at least 1 year
  • Requires carriers to implement electronic prior authorization systems using standardized formats, and prohibits artificial intelligence from being the sole basis for denying medical necessity determinations
  • Establishes a 15-member task force to study prior authorization's impact on health care costs and access, with a report due by July 31, 2026, and authorizes the Division of Insurance to implement uniform rules by April 1, 2027

Legislative Description

Relative to reducing administrative burden

Last Action

Bill reported favorably by committee and referred to the committee on Senate Ways and Means

9/29/2025

Committee Referrals

Ways and Means9/29/2025
Health Care Financing7/7/2025
Mental Health, Substance Abuse and Recovery2/27/2025

Full Bill Text

No bill text available