Massachusetts Medical Society: Testimony in Support of An Act Providing Access to Patient Protection Services for Masshealth Consumers (Malia)

Testimony in Support of An Act Providing Access to Patient Protection Services for Masshealth Consumers (Malia)

The Massachusetts Medical Society wishes to be recorded in support of House bill 1963, legislation that will provide MassHealth consumers access to patient protection services afforded by sections 12 through 14 of chapter 176O of the general laws.

House bill 1963 would extend health insurance consumer protections contained in chapter 176O that are not currently available to MassHealth consumers.  These protections include utilization reviews, formal internal grievance processes, and review panels for filed complaints.  Expanding these protections to cover MassHealth members will help to reduce administrative costs by setting expedited timelines for utilization reviews, clarifying bases for adverse determinations, and freeing physicians from excessive administrative burden caused by the complicated prior authorization processes.  Additionally, patients would receive greater protections regarding adverse determinations through the use of an expedited resolution policy and a review panel established by the Office of Patient Protection.

Adopting these protections, already provided to consumers of private insurance by the Massachusetts Patient’s Bill of Rights, would decrease disparities in health care by ensuring parity in access to the aforementioned benefits for MassHealth patients and the physicians who treat them.

Additionally, this bill would help to address the issue of “administrative complexity,” which the Health Policy Commission has identified as an area of explicit focus.  Members of the Health Policy Commission’s Advisory Council were surveyed regarding numerous types of administrative complexity and specifically ranked prior authorizations as one of two areas of high priority concern.  House bill 1963 helps to address these issues by streamlining and explicating more precise timelines for these administrative procedures.

The Medical Society appreciates this opportunity to be heard and recommends favorable reporting of House bill 1963.

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