H 4616 Massachusetts House · 194th Legislature (2025-2026)

An Act improving the health insurance prior authorization process

H 4616 requires health insurance companies in Massachusetts to publicly list all medical services, drugs, and procedures needing pre-approval (prior authorization) on their websites. Insurers must also report annual data on approval/denial rates, processing times, and appeal outcomes in a standardized format. The bill prevents insurers from denying coverage for services already approved or denying claims over minor administrative errors (unless fraud is proven), and bans retrospective denials unless fraud occurred. This directly affects insurers, healthcare providers, and patients by making the authorization process more transparent and reducing unexpected coverage denials.
Bill status in committee 1 of 4 stages cleared
Introduction
Oct 2025
Committee Review
Floor Vote
Governor
Introduced Oct 20, 2025 Last action Jul 29, 2026
Floor votes

How they voted

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Full legislative history

Actions timeline

Total actions
7
Key actions
2
Committee
3
Jul 29, 2026
Committee
Committee recommended bill ought to pass and referred to the committee on House Ways and Means
lower
Oct 20, 2025
Lower · Passed
Reported favorably by committee and referred to the committee on Health Care Financing
lower
Oct 20, 2025
Lower · Passed
Reported from the committee on Financial Services
lower
0 primary · 26 co-sponsors

Sponsors

No sponsor information available.