An Act streamlining the prior authorization process
Generates a plain-language summary of the bill text and history.
| Date | Branch | Action |
|---|---|---|
| 4/1/2026 | Senate | Accompanied a study order, see S3038↗ |
| 3/19/2026 | Senate | Reporting date extended to Tuesday March 31, 2026 |
| 12/11/2025 | Senate | Bill reported favorably by committee and referred to the committee on Health Care Financing |
| 10/20/2025 | Joint | Hearing scheduled for 07/15/2025 from 10:00 AM-01:00 PM in A-2 |
| 7/3/2025 | Joint | Hearing scheduled for 07/15/2025 from 10:00 AM-01:00 PM in A-2 |
| 2/27/2025 | House | House concurred |
| 2/27/2025 | Senate | Referred to the committee on Financial Services |
No additional cosponsors.
| Committee | Recommendation | Vote |
|---|---|---|
| J11 | Favorable | 1 entries |
| J24 | Accompanied | — |
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.
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.