An Act relative to external reviews and patient protection

HD 3046 requires external medical reviews for denied treatments to be conducted by a Massachusetts-licensed physician certified in the relevant specialty. This physician must identify themselves to the patient, provide a detailed written report with peer-reviewed citations, conduct physical exams when needed, and carry malpractice insurance. The bill also allows patients to appeal denied reviews in superior court and, if successful, recover all attorney fees and costs from the health plan. It directly affects patients challenging insurance denials for medical care. These changes aim to increase transparency and accountability in the external review process.