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.
