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Bill S.706
Notwithstanding any special or general law to the contrary, the commissioner of insurance shall develop a list of services that are appropriate for real-time automated approvals of prior authorization requests of covered services when the clinical information submitted electronically by a provider clearly establishes that the patient meets the medical necessity criteria for the requested service. In developing the list, the commissioner shall seek input from the Massachusetts Collaborative and other interested stakeholders, and focus on services with high prior authorization approval rates and clearly established clinical treatment protocols. The division of insurance shall publish the list on its website not later than January 1, 2027. Carriers that require prior authorization for services on the published list shall implement an automated process for the real-time approval of covered services that clearly meet medical necessity criteria not later than January 1, 2028.
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