An Act preventing inappropriate denials by insurers for medically necessary services

This bill requires health insurance companies in Massachusetts to pay for medically necessary services that are covered under a patient's plan if the treating provider followed the insurer's clinical review and authorization rules. It prevents carriers from denying claims based on minor administrative or technical errors, except in cases of suspected fraud, and limits the time insurers have to recoup payments to twelve months. Additionally, the law mandates that providers receive detailed written notice at least thirty days before any payment adjustments are made and ensures that claims denied due to unintentional errors are reviewed within thirty days to determine medical necessity.